Sr. Business Analyst

Role overview

Responsibilities

• Lead requirements conversations and manage end-to-end requirements across stakeholders.
• Develop business and functional requirements for claims, enrollment, provider, authorization, and payment systems.
• Translate healthcare business needs into functional and technical requirements and create solutions using the core-admin ecosystem.
• Negotiate client processes and collaborate with business, management, IT, and offshore teams to meet project objectives.
• Identify automation, performance, and reusability opportunities; create workflow, system-context, and swim-lane diagrams.
• Plan requirements alongside implementation schedules and communicate risks and dependencies.
• Elaborate user stories with offshore analysts and conduct requirements walkthroughs.
• Collaborate with development and QA, contribute to Agile ceremonies and go-live evaluations, and demonstrate MVPs.

Qualifications and experience

• Knowledge and experience in healthcare payer domains, including claims adjudication, enrollment, provider, and payment.
• Experience mapping healthcare EDI transactions, including 837, 834, 835, 270/271, 276/277, and 278.
• Experience translating business requirements into technical requirements using EDI implementation, companion, or TR3 guides.
• Experience documenting requirements or user stories and communicating them to technical teams, partners, vendors, or product teams.
• Experience working in an onshore/offshore model is required.
• Bachelor’s degree or higher in a business or technical field; 10+ years of relevant business analysis experience.
• Awareness of Agile tools and Scrum methodologies; strong communication skills are expected.
• Exposure to HealthEdge, TriZetto, NASCO, Advantasure, or Change Healthcare ecosystems is listed; HealthEdge applications are a plus.
• Understanding of SQL and XSDs is a plus.

Workplace and travel

• Geographic responsibility is remote within the United States.
• Travel may be up to 25%.

Employment and compensation

• Employment is full-time and permanent.
• Salary is listed as USD 120,000–140,000 yearly.