Technical Rules Analyst (Health Care Services)

Title: Technical Rules Analyst (Health Care Services)

Company: WorkSafeBC
Location: Richmond, British Columbia
Job Type: FullTime

Description:

Our Health Care Operations department is seeking a Technical Rules Analyst to ensure timely referrals-to-treatment for injured workers and accurate payments to healthcare providers. This role involves shaping the billing experience for healthcare providers, translating business policies into clear rules, and optimizing systems for efficiency. The position includes analyzing data, recommending improvements, and implementing rule enhancements to enhance payment accuracy.

Key Responsibilities:

Develop, analyze, and maintain business rules for an automated claims adjudication engine

Lead cross-divisional committees to implement rule changes

Analyze data to identify gaps and develop recommendations for payment accuracy

Support the implementation of rule changes and system updates

Develop communication strategies for distributing information

Consult on projects and provide work direction to the technical rules administrator

Qualifications:

Plan, prioritize, and monitor complex activities

Understand and communicate business and technical requirements

Apply project management techniques

Present data using MS Excel and Word

Background and Experience:

Degree in business administration or related field

Minimum of three years of experience in business, data, or systems analysis

Experience in healthcare and using MS Excel, PowerPoint, and Word

Working knowledge of Tableau and/or SQL

Before employment, must confirm legal entitlement to work in Canada. WorkSafeBC promotes safe workplaces and provides compensation and support for injured workers. Benefits include competitive salary, additional compensation, vacation time, health, dental, sick leave, and disability coverage. Applications are open until 4:30 p.m. PST on the closing date.

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Title: Technical Rules Analyst (Health Care Services)
Company: WorkSafeBC
Location: Richmond, British Columbia
Overview Our Health Care Operations department is looking for a Technical Rules Analyst who will champion the systems and processes that make timely referralstotreatment possible for injured workers and ensure accurate and timely payments to those that care for them.In this role, your work will shape the billing experience of health care providers who care for injured workers. You'll be a bridge between Health Care Operations and technology, transforming complex business policies into clear actionable rules that keep our health care systems running smoothly. Your ability to translate business needs into precise and understandable technical specifications will help us optimize, upgrade, build and maintain systems that create a positive experience for health care providers.You will also dive into health care and claims data to uncover opportunities, recommend evidencebased improvements, and implement rule enhancements that make our payment systems more accurate and efficient.There are 2 temporary opportunities, 12 and 15 months.How you'll make a difference: You'll help protect the financial integrity of B.C.'s workers' compensation system, ensuring we serve British Columbians now and in the future.Where you'll workAt WorkSafeBC, we offer a hybrid work model that combines working remotely, and in our offices based on the operational needs of the position.What you'll do

Develop, analyze and maintain business rules, based on business and legislative requirements, that drive an automated claims adjudication engine
 Lead crossdivisional working committees to review, prioritize, and implement rule changes
 Analyze health care and claims data to identify gaps, inefficiencies, or inconsistencies within existing rules, and develop evidencebased recommendations to improve payment accuracy and system performance
 Support the implementation of recommended rule changes by collaborating with the appropriate business teams throughout design, testing and deployment
 Develop communication strategy for distributing information to support rule changes, system updates, and impacts to business processes within the claims management system
 Provide input into contract negotiation, development, and proposed service delivery changes to health care programs, identifying the potential implementation impact to the technical systems that support the programs
 Consult on and implement projects by preparing schedules for program enhancements, identifying requirements, milestones, and dependencies, developing comprehensive test plans, and measuring expected results
 Provide work direction to the technical rules administrator

Is this a good fit for you?We're looking for someone who can:

Plan, prioritize, coordinate, and monitor complex and concurrent activities and projects to consistently meet deadlines in a changing environment
 Take initiative, provide leadership, delegate and monitor work
 Understand business requirements and technical information and communicate clearly to business and technical audiences, verbally and in writing
 Apply project management techniques, including planning, analyzing, implementing, monitoring, and followup
 Present data using MS Excel and Word

Your background and experience

A degree in business administration or a related field
 A minimum of three years of experience in business analysis, data analysis, or systems analysis
 Experience in healthcare is an asset
 Experience presenting data using MS Excel PowerPoint and Word
 Working knowledge of Tableau and/or SQL is an asset

We'll consider an equivalent combination of education and experience.Important to knowBefore we can finalize any offer of employment, you must:

Confirm you're legally entitled to work in Canada

Who we are At WorkSafeBC, we promote safe and healthy workplaces across British Columbia. We partner with workers and employers to save lives and prevent injury, disease, and disability. When workrelated injuries or diseases occur, we provide compensation and support injured workers in their recovery, rehabilitation, and safe return to work. We're honoured to serve the 2.49 million workers and 263,000 registered employers in our province.What's it like to work at WorkSafeBC?It's challenging, stimulating, and rewarding. Our positions offer diversity and opportunities for professional growth. Every day, the work we do impacts people and changes lives. What we do is important, and so are the people we do it for.Our ability to make a difference relies on building a team with a rich variety of skills, knowledge, backgrounds, abilities, and experiences that reflects the diversity of the people we serve. We are committed to fostering a welcoming, inclusive, and supportive work culture where everyone can contribute as their best, authentic self.Learn more: Discover .Our benefits As a member of our team, you'll have access to services and benefits that help you get the most out of work  and life. Along with a competitive salary, your total compensation package includes:Extra 4% of your salary in lieu of benefits and 4% in lieu of vacation from the day you start.Once you've worked for 1820 hours (approximately 12 months), you'll switch to getting:

3 weeks of vacation with regular increases based on years of service
 Extensive health care and dental benefits
 Sick leave and longterm disability coverage

Learn more: Find out .Want to apply?

Applications are welcomed immediately, however must be received no later than 4:30 p.m. PST on the closing date.
 Please note that we will be starting assessments prior to the closing date.

We encourage all qualified applicants to apply. If you require an accommodation in the assessment process, please email when you submit your application

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