Business Analyst

About the role

The Business System Analyst (BSA) will help in capturing the business requirements to run the Health plan customer’s Core admin business functions while implementing UST HealthProof’s core-admin ecosystem. The BSA will work with the Health Plan Customers, third party vendors/partners, Internal product teams, solution architects and product owners to define the business rules and processes required for implementation.

Responsibilities

• Leading business requirement conversations with customer and internal teams.
• Managing the end-to-end requirements involving all the stakeholders.
• Responsible for developing business and functional requirements for Claims, Enrollment, Provider, Authorization, Payment systems.
• Create solutions for current business processes using UST HealthProof’s core-admin ecosystem.
• Negotiate with client to develop processes that are current and applicable to the situation.
• Collaborate with business users, management, IT, and offshore staff to ensure the finish product meets project objectives and client expectations by applying ‘Agile like’ project methodology.
• Instrumental in analysing the healthcare business requirements and translating them to functional and technical requirements.
• Identify opportunities for automation, performance improvements, reusability.
• Create high level workflow diagrams and system context diagrams.
• Document the understanding of the process flow using swim lanes diagrams.
• Produce the Requirements plan that aligns with the overall Project Implementation plan.
• Dictate the risks and dependencies in the timely manner with the Customer to complete the requirement gathering to meet up with the project plan dates.
• Must work with Offshore Business Analysts to elaborate user stories.
• Conduct Requirement walk through with the customer and internal/external stakeholders.
• Collaborate with the development team & QA team to ensure the finish product meets project objectives and client expectations.
• Contribute towards sprint planning, retrospective, go-live/no-go-live evaluation meetings.
• Conduct Demo of MVPs for the customer.

Requirements

You bring:

• Knowledgeable in Healthcare insurance domain (Medicare, Medicare Advantage, Medicaid, ACA or Commercial).
• Exposure to healthcare eco-systems from partners like HealthEdge, TriZetto , NASCO, Advantasure or Change Healthcare.
• Experience with mapping of EDI healthcare transactions (837, 834, 835,270/271, 276/277, 278).
• Awareness to Agile tools and scrum methodologies.
• Communication skills with peers, customers, and partners including the ability to convey information effectively.
• Experience in analysing the business requirements and translating/mapping them to technical requirements in EDI technology by analysing implementation/companion/TR3 guides.
• Experience documenting requirements or user stories and communicating the requirements to technical teams, partners/vendors or product teams.
• Experience working in an onshore/offshore model is a must.
• Experience working HealthEdge applications like HealthRules Payor or GuidingCare is a plus.
• Understanding of SQL, XSDs is a plus.

Qualifications

Bachelor’s degree or higher in business or technical field, 10+ years of relevant work experience in business analysis.

Skills

Knowledgeable in Healthcare insurance domain (Medicare, Medicare Advantage, Medicaid, ACA or Commercial).

Exposure to healthcare eco-systems from partners like HealthEdge, TriZetto , NASCO, Advantasure or Change Healthcare.

Experience with mapping of EDI healthcare transactions (837, 834, 835,270/271, 276/277, 278).

Awareness to Agile tools and scrum methodologies.

Communication skills with peers, customers, and partners including the ability to convey information effectively.

Experience in analysing the business requirements and translating/mapping them to technical requirements in EDI technology by analysing implementation/companion/TR3 guides.

Experience documenting requirements or user stories and communicating the requirements to technical teams, partners/vendors or product teams.

Experience working in an onshore/offshore model is a must.

Experience working HealthEdge applications like HealthRules Payor or GuidingCare is a plus.

Understanding of SQL, XSDs is a plus.