Business Systems Coordinator

Who is PBC Solutions?   
   
PBC Solutions Ltd. is a wholly owned subsidiary of PBC Health Benefits Society (operating as Pacific Blue Cross). Our mandate is to design, transform, and deliver the benefits and claims administration services offered by governments and other large organizations along with our consortium partners Advanced Solutions (which is our information management partner), NTT DATA, and EY.   

Starting in the spring of 2023, PBC Solutions will administer Health Insurance BC Services (HIBC) on behalf of the BC Ministry of Health. HIBC Services administers medically-necessary insured doctor and hospital services through the Medical Services Plan (MSP) and drug coverage through the PharmaCare and Fair PharmaCare programs. 

Department Overview 

On behalf of the B.C. government, Health Insurance BC (HIBC) administers medical coverage through the Medical Services Plan (MSP) and drug coverage through the PharmaCare and Fair PharmaCare programs. With a staff of ~280 unionized employees and excluded managers, the HIBC Operations department delivers services measured by Service Level Requirements (SLR) and Service Level Objectives (SLO) via three teams:  

• Document Operations (Document Management, Document Processing, Admin Review, and Information Support and Prosthetics and Orthotics)   
• Practitioner and Patient Services (Provider Programs, Benefit Services, Billing Support, and In Province and Out of Country Adjudication)   
• Operational Support Services (Business Systems Coordinators – RAPID, Claims and PharmaNet, Production Control, Support Analyst and Support Coordinator, Correspondence Liaison Unit, Quality Assurance, and Service Desk)  

Position Summary

The Claims Business System Coordinator applies extensive business knowledge to support the development and implementation of Health Systems. The position is involved with both long-term (multi-year) and short-term projects. The position delivers multiple services to these projects by providing business acceptance testing, user business and systems support, advice and guidance in operations, data integrity and maintenance of the health systems. This work requires high accuracy as both financial information and personal medical information are reviewed, updated, and/or verified frequently.

This position is designated as a Grid level 18, with a range of $33.46- $38.18 per hour.

Primary Duties

• Provide Business Acceptance Testing (BAT) for projects and system upgrades to ensure changes meets Operations workflows and procedures. 
• Respond to queries, to provide support for system users of HIBC applications (including data access procedures and transactions). 
• Perform and document compliance evaluations in accordance with client standards. 
• Understand and comply to PBC Solutions, legislated and client policies and work procedures accurately, 98% of the time to meet our Quality Service Level Requirements (SLR) and to provide excellent customer service. 
• Adhere to your work commitment and daily schedule 95% of the time so that PBC Solutions can meet its business goals efficiently and reliably. 
• Manage your interactions with callers, clients, and colleagues respectfully, collaboratively, and professionally to contribute to a harmonious, productive work environment

Provide Business Acceptance Testing (BAT) for projects and system upgrades. 

• Participate in the review of business requirements and functional specifications to ensure all user paths are covered 
• Participate in the development of test strategies and plans 
• Participate in PI (Program Increment) Planning quarterly events and attend the resulting ongoing meetings 
• Review functional test cases and results 
• Identify BAT testing strategies, objectives, scope, timeframes, scheduling, and deliverables 
• Estimate BAT effort required for projects and enhancements
• Create business test scenarios to be executed during the BAT phase 
• Organize and lead BAT testers through test execution and final sign off
• Track BAT test results 
• Analyze automated test case results 
• Validate successful migration of changes to production environment, including data conversion 
• Validate production data accuracy for payments, reports, reconciliations 
• Add or update adjudication rules via a custom in house coding application 
• Create rule specification document, creating test scenarios and data, and track BAT test results 
• Communicate with all stakeholders throughout the system development lifecycle, 

Respond to queries. 

• Troubleshoot, document, and resolve system issues and queries for a diverse group of stakeholders 
• Escalate issues to the appropriate IT area when required and collaborate to resolve end-user requests in a timely manner 
• Proactively seek ways to enhance application performance 
• Update database and systems support tables 
• Analyze data errors and determine appropriate solution; correct data and document solution and actions taken. 
• Track all requests within a work and time tracking management system. 
• Prepare a variety of routine and ad hoc reports 

Understand and comply with policies/procedures set by PBC Solutions, legislation, and our clients. 

• Comply to all regulations, policies, and procedures, with minimal intervention 
• Learn new policies, procedures, and computer applications within designated timelines 
• Escalate work that is beyond the level you are assigned 
• Obtain required approvals from designated personnel 
• Document notes and actions, in our systems, that are clear, objective, and useful to others 
• Utilize designated channels and systems for making recommendations, communicating, reporting, etc. 
• Report non-compliance of policies and procedures, regardless of the cause 

Adhere to your work commitment and daily schedule. 

• Manage personal time with minimal impact to work time 
• Track and update weekly/monthly schedule expectations, as they are relayed 
• Update your Scheduler/supervisor with changes to your schedule as soon as you are aware of them, and with consideration of our planning needs and the BCGEU Collective Agreement
• Perform the work you are assigned within the designated time
• Report your time accurately, in the appropriate system, within the deadlines

Manage your interactions with callers, clients, and colleagues respectfully, collaboratively, and professionally to contribute to a harmonious, productive work environment. 

• Articulate concerns, ideas, and opinions in a professional manner 
• De-escalate emotionally charged situations/calls
• Utilize pro-social skills (sharing, taking turns, manners, negotiation, problem solving, smiling, impulse control, interrupting/listening, dealing with mistakes, making decisions, etc.)

Required Education and Experience

• Diploma or completed post-secondary coursework in business or public administration, computer technology, or systems administration or equivalent work experience in a related business environment
• Minimum two years’ experience in a business/production role in a medium to large corporate or government organization 
• Advanced knowledge of HIBC policies preferred
• Advanced knowledge of Microsoft Office, Outlook, Microsoft Word and Excel and the ability to operate standard office equipment

Knowledge, Skills, and Abilities

• Knowledge of on-line computer-based health programs, services and systems would be an asset
• Advanced knowledge of HIBC systems of record preferred 
• Demonstrated aptitude for continuous learning and innovative thinking
• Demonstrated ability to investigate, troubleshoot, and solve various technological problems
• Attention to detail
• Strong documentation skills

Competencies 
•    Effective Communication
•    Managing Conflict
•    Feedback
•    Multiple demands and Time management
•    Organizational Savvy
•    Decision Quality 
•    Balancing Stakeholders 
•    Problem Solving

What's in it for you 

We offer a robust health & dental benefits plan, with flexible options that will meet you and your family's needs. We also offer a Defined Benefit Pension Plan (PSPP), for all eligible employees. 

We strive to create a workplace where everyone feels valued and employees feel empowered to freely participate and contribute regardless of race, ethnicity, gender or gender identity, sexual orientation, religion, ability, education level, parental status, or socioeconomic status. 
 
PBC Solutions is an equal opportunity employer and welcomes applications from all qualified candidates.  

To request an accommodation in completing this application, pre-employment testing, interviewing or otherwise participating in the employee selection process, please direct your inquiries to hr@pbcsolutions.ca 

Does this opportunity resonate with you?  
 
Are you seeking a work environment that will challenge you, provide stretch opportunities, and support your success and growth? Then you've found your ideal work environment - Apply today please We'd love to talk with you to explore this opportunity further with you. 
 
Please note, if selected for this opportunity, you will be required to undergo a background check in accordance with PBC Solutions policies. 
 
We sincerely thank all candidates for their interest, however only those selected to continue in the recruitment process will be contacted. 
 
Please apply by JUNE 19, 2024 AT 3:00 PM PST . An eligibility list may be established for this position. 

How we work 

Our Guiding Principles  

Honesty – We will be truthful.  We will create a safe environment to communicate proactively, openly and with respect.  We will be transparent and genuine with our interests.  

Integrity – We will act consistently to do the right thing and ensure our words and actions align.  Embracing opportunities and challenges, we will live our shared values and vision.  

Reciprocity - We will strive for fair and balanced exchanges leveraging our unique strengths and resources, recognizing this requires an ongoing give and take.  We will win and lose as one.    

Autonomy – We respect and acknowledge the interests of each party.  We trust each other to make decisions and act based on our diverse strengths to achieve our mutually desired outcomes.    

Loyalty – We will be bold, brave, and committed to our relationship.  As partners, we will advocate for one another, celebrate our successes, and have each other’s back through our challenges.    

Equity – We commit to a balanced partnership.  We will make decisions and act based on a fair assessment of capabilities, risks, constraints, and opportunities to achieve mutual success.    

Our Intended Behaviours  
Communication – We actively communicate in a timely, open, respectful, and responsive manner with the intent to gain understanding and find solutions.    
Flexibility – We will be agile, adaptable, and creative to enable responsive service delivery and embrace challenges and change with an open-minded and positive attitude.   
Perspective – We seek to understand interests, assumptions, actions, and diverse backgrounds by actively sharing and exploring all points of view.   
Focus – We will use our Shared Vision as our North Star to evaluate, prioritize, and deliver successful results.