CareFirst Careers

Operations Analyst (Patient-Centered Medical Home)

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Resp & Qualifications

PRINCIPAL ACCOUNTABILITIES:  Under the general direction of the Director, PCMH Operations, the incumbent’s accountabilities include, but are not limited to, the following:

Addressing the ongoing business issues and opportunities with the PCMH and TCCI business areas.

  • Proactively assess business situations, formulate gap hypothesis and develop practical recommendations for leadership.
  • Lead the identification, tracking and resolution of operational and technical issues by coordinating efforts with cross-functional teams within the organization.
  • Compiles, analyzes and interprets data and makes strategic and tactical recommendations to business managers.
  • Perform data analysis, produce operational reporting, and derive business conclusions for management.
  • Track and manage open issues and plan for resolution. Troubleshoot systems problems, identify cause of problems, work with appropriate group to correct problem.
  • Maintain communications with technical counterparts to guide the issues to cross-functional resolution and adopt best practices and ensure integration of specific application architecture into overall enterprise technology strategy.

Track and/or participate in the enhancements, automations, and implementations of current and future business processes and technical systems.

  • Review and summarize business requirements for IT and business process enhancements.

Acts as owner of one or more process and provides support to other team members on complex project and program deliveries.

  • Support Project Leads within the team with Project Management techniques like deliverable tracking, budget compliance, and reporting.
  • Use project management techniques, monitor project, request status, workload and ensure deliverables of high quality, effectiveness and timeliness.
  • Prepare, implement, monitor, and update the project plan.  Coordinate with the business owner and upper level management to ensure the actions are consistent with the approved plan.


Required: This position requires a BA/BS degree in Computer Science or Business or equivalent  work experience (4 years) in business/process analysis in lieu of a Bachelors degree. In addition, the incumbent must have 3-5 years of direct Analyst experience.

  • Experience in business process analysis, work flow and task analysis.
  • Proven ability to work well as a team.
  • Demonstrated ability to lead problem solving business/technology teams and projects.
  • Technical writing experience and training experience.
  • Must demonstrate understanding of industry standard Business Analysis and Project Management Lifecycle.

Required Abilities/Skills: 

  • Relevant business subject matter expertise. 
  • Ability to work independently and as part of a team.
  • Excellent interpersonal skills including the ability to build consensus and agreement and bring resolution to contentious issues and entrenched interests.  
  • Proven ability to lead problem-solving discussions.
  • Excellent analytical and problem-solving skills, and great attention to detail. 
  • Advanced written and verbal communication skills. 
  • Excellent organizational skills and ability to set priorities and handle multiple projects concurrently. 
  • Extensive PC skills including Microsoft office software such as Word, Excel (Pivot Tables, VLOOKUP, & Graphing), VISIO and Power Point.
  • Experience in accurately modeling requirements using at least one if not more of the following: Functional Decomposition, Data Flow Diagrams, User Context Diagrams, Activity Diagrams, Decision Needs, Workflow modeling, Use Cases, Use Case Model Survey and Use Case Specification, Process Modeling, Prototyping
  • Demonstrated leadership skills
  • Must be able to effectively work in a fast paced environment with frequently changing priorities, deadlines, and workloads that can be variable for long periods of time.  Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence.   Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.


  • Knowledge of organization and operations of the business area supporting.
  • Understands basic Internet and client/server architectures.
  • Proficiency in Microsoft Access, Database Management, SQL, Microsoft SQL Server
  • Experience with Business Intelligence and Analytics software such as MicroStrategy, Power BI, Tableau
  • Knowledge of the CareFirst Defined Processes.
  • Experience with healthcare insurance industry, especially BCBS plans.


Department: Case Management

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer.  It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Hire Range Disclaimer

Actual salary will be based on relevant job experience and work history.

Where To Apply

Please visit our website to apply:

Closing Date

Please apply before: 6/21/2018

Federal Disc/Physical Demand

Note:  The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.


  • The physical demands described here are representative of those that must be met by the incumbent to perform the essential duties and responsibilities of the position successfully.  Requirements may be modified to accommodate individuals with disabilities.
  • Must be able to work in an office setting, primarily seated while performing duties for a minimum of 8 hours per work day.
  • Must be able to provide own transportation to drive regularly to physician’s office and to satellite CareFirst Blue Cross Blue Shield offices.
  • Walking and standing is required.  Lift weight up to 25 pounds on occasion.
  • Hands are regularly used to write, type, key and handle or feel small controls and objects.  Must be able to type and to speak on the telephone simultaneously.
  • Must have the ability to communicate verbally effectively. Auditory ability to actively listen.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship

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