Medical Mutual employees must submit their applications through MySource.

Note: This is a hybrid position located in Brooklyn, OH, with a three-day per week onsite requirement. Candidates must be located in the Cleveland/Brooklyn area.

Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans.

Senior Business Systems Specialist

Job Summary: ** **

Works with management, external vendors, and Information Systems to define, develop, test, and implement new operations business systems (e.g., Claims, Membership, Billing, Customer Care) and processes of increased complexity and size. Serves as a project leader to identify dependencies, constraints, and resources. Communicates system changes to users and Training. Provides coordination and technical guidance to internal and external team members.

Responsibilities:

Acts as a project leader in the development and testing of major system modifications. Acts as a consultant to other departments regarding the impact of system changes.
Analyzes, evaluates and/or recommends business requirements for new or enhanced systems. Works with Information System Development (ISD) to ensure system integrity.
Analyzes systems issues to determine system or procedural problems. Researches recreate and monitors reported issues using procedural and technical system documentation.
Provide technical and testing guidance to more junior staff in support of major system troubleshooting, system modifications and documentation.
Performs other duties as assigned.

Lead Business Systems Specialist

Job Summary: ** **

Leads the analysis and solutions in support of technical process and system changes and reporting outcomes for operations systems (e.g., Claims, Membership, Billing, Customer Care). Leads various teams to ensure the development, testing, implementation and maintenance of claims and customer care end-to-end processing.

Responsibilities:

Creates solutions for complex multi-departmental projects as a liaison between various business and Information Systems departments.
Resolves project obstacles that may impact project milestones from being achieved.
Identifies and streamlines processes and implements procedural solutions for processes or projects.
Determines priorities and facilitates status meetings including findings and recommendations.
Performs other duties as assigned.

Qualifications:

Senior Business Systems Specialist

Bachelor’s degree in business administration or related field or equivalent combination of education and experience.
5 years progressive experience as a Business Systems Specialist or equivalent experience with software quality assurance and testing processing systems in multiple operational departments.
Project Management Certification preferred.
Comprehensive knowledge of Project Management methodologies.
Comprehensive knowledge of claims adjudication systems and processes and contract/regulation language.
Strong project management skills; ability to handle multiple, concurrent projects under tight deadlines.
Demonstrated proficiency in research techniques and system analysis.
Advanced Microsoft Office skills.
Advanced proficiency with Power BI, Tableau, SQL tools preferred.

Lead Business Systems Specialist

Bachelor’s degree in business administration, information systems or related field or equivalent combination of education and experience.
6 years progressive project administration experience in health insurance operations and/or business systems or other relevant experience.
Experience working and building intra/inter departmental relationships.
Project Management Certification strongly preferred.
Business Analysis Certification preferred.
Comprehensive knowledge of project management methodologies.
Comprehensive knowledge of claims adjudication systems and processes and contract/regulation language.
Strong project management skills; ability to handle multiple, concurrent projects under tight deadlines.
Demonstrated proficiency in research techniques and system analysis.
Ability to understand and translate technical concepts.
Advanced Microsoft Office skills.
Advanced proficiency with Power BI, Tableau, SQL tools preferred.

Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That's why we offer an exceptional package that includes:

A Great Place to Work:

We will provide the equipment you need for this role, including a laptop, monitors, keyboard, mouse and headset.
Employees have access to on-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available. Enjoy the use of weights, cardio machines, locker rooms, classes and more.
On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters.
Discounts at many places in and around town, just for being a Medical Mutual team member.
The opportunity to earn cash rewards for shopping with our customers.
Business casual attire, including jeans.

Excellent Benefits and Compensation:

Employee bonus program.
401(k) with company match up to 4% and an additional company contribution.
Health Savings Account with a company matching contribution.
Excellent medical, dental, vision, life and disability insurance — insurance is what we do best, and we make affordable coverage for our team a priority.
Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits.
Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time.
After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption.

An Investment in You:

Career development programs and classes.
Mentoring and coaching to help you advance in your career.
Tuition reimbursement up to $5,250 per year, the IRS maximum.
Diverse, inclusive and welcoming culture with Business Resource Groups.

About Medical Mutual:

Medical Mutual’s status as a mutual company means we are owned by our policyholders, not stockholders, so we don’t answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us.

There’s a good chance you already know many of our Medical Mutual customers. As the official insurer of everything you love, we are trusted by businesses and nonprofit organizations throughout Ohio to provide high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Our plans provide peace of mind to more than 1.2 million Ohioans.

We’re not just one of the largest health insurance companies based in Ohio, we’re also the longest running. Founded in 1934, we’re proud of our rich history with the communities where we live and work.

We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing.

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