Job Description

Healthcare Business Analyst

We are seeking a passionate, results-oriented Business Analyst in the healthcare payer domain with Health Plan administration experience of self-funded clients who excels in client interactions, and can collaborate effectively with stakeholders to analyze, define and manage requirements for client or product. The ideal candidate will have worked in-depth in healthcare payer domain within Group, member, Benefits & Claims Administration, Claims Payment & Vendor integration space. This person must possess a blend of business and technical savvy; strong communication skills to collaborate across internal and external stakeholders.

Responsibilities:
- Serves as a liaison between the business programs community and IT organization to create business requirements and assist with technical solutions to meet project needs.
- Analyze and document business requirements and processes; use and promote industry standard analysis techniques, such as data flow modeling, use-case analysis, workflow analysis, business process mapping.
- Break down high level information gathered into details including sources of data, data types, users, user types, interface components, interface navigation needs, reporting needs, and administrative system needs.
- Translates high level business requirements into functional specifications for the IT organization and manages changes to such specifications.
- Actively participates in all phases of SDLC design, development, testing and support.
- Produces business design document based on product and solution requirements.
- Support Quality Assurance (QA) Testing by developing test plans, test cases and acceptance criteria to validate digital solutions against business requirements and regulatory standards. Participate in QA testing activities, identify defects, and collaborate with teams to ensure timely resolution and delivery of high-quality products and solutions.
- Partner with stakeholders on requirements prioritization, solution approach and alternatives, and manage requirements changes to ensure developed solution conforms to business needs.

This position is a fulltime, direct opportunity with our Healthcare client who is offering a generous salary and benefits package. Ideal work location is Westbury NY (Long Island) with a hybrid schedule (3 days onsite). Alternatively, this position can be staffed remotely for candidates that reside in one of the following states: CO, CT, FL, GA, IL, MA, MD, MI, MN, MO, NC, NJ, NY, OH, PA, SC, TN, TX, WA.

Required Skills

- Bachelors degree in IT, Healthcare Administration and/or progressive experience.
- 4+ years of BA experience in onboarding new self-funded clients or implement product in Multi-employer Trust or Health Plan Administration.
- Healthcare industry knowledge
- Familiar with claims administration systems and terminology - working knowledge of Eligibility and Enrollments, Administration of Plans, Benefits, Claims, Accumulators, and Provider Payments
- Experience with SFTP, EDI X12 transactions 834, 837, 270/1 is a plus.
- Communicate effectively with internal and external stakeholders
- Strong attention to detail and perform consistent work product validation/QA
- Strong analytical skills
- Knowledge of MS SQL Server Managed Studio ability to create SQL queries that includes but not limited to extract data, update and insert functions
- Proficient in Microsoft Office including Outlook, Excel, Visio, PowerPoint and Word.

Apply Now

Job Tags

Full time, Work at office, Remote work,

Similar Jobs