Business Analyst III – Clinical Optimization Delivery

About the role

This Business Analyst III opportunity within Medica's Clinical Services division supports optimization, governance, compliance, configuration, analysis, and continuous improvement of clinical operations, systems, business rules, communications, and data processes across multiple lines of business.

Responsibilities

• Analyze and document business processes, system requirements, workflows, business rules, and operational procedures supporting Clinical Services.
• Translate business, clinical, operational, and regulatory requirements into clear functional and technical requirements.
• Partner with Clinical Operations, Compliance, IT, Product, vendors, and business stakeholders to design and implement business and system solutions.
• Maintain and update business process documentation, workflows, business rules, and operational procedures.
• Identify opportunities for process improvement, operational efficiency, and system optimization.
• Support continuous enhancement of clinical systems and related operational processes.
• Serve as a subject matter expert (SME) for clinical systems, clinical communications and letter management platforms, business rules, and operational processes.
• Provide guidance and support to business, operational, and technical stakeholders regarding system functionality and business processes.
• Collaborate cross-functionally to resolve issues, support implementations, and ensure successful adoption of solutions.
• Ensure business rules, system requirements, and operational processes align with organizational, clinical, and regulatory standards.
• Support governance activities through accurate documentation, requirements traceability, and process compliance.
• Utilize process and system knowledge to support data integrity, reporting requirements, and decision-making activities.

Requirements

• Bachelor's degree or equivalent experience in related field
• 5+ years of relevant experience in business analysis, preferably in healthcare or clinical systems
• 3+ years of experience working in a health plan
• Experience working with cross-functional teams, including IT and business stakeholders
• Strong analytical and problem-solving skills with attention to detail
• Ability to translate complex business needs into actionable requirements
• Excellent communication and stakeholder collaboration skills
• Strong organizational skills with ability to manage competing priorities
• Ability to work independently and drive outcomes in a fast-paced environment

Preferred Qualifications

• Experience with clinical systems, utilization management, or care management workflows
• Proficiency in data and reporting tools (e.g., SQL, Excel, Power BI, Tableau, JIRA)
• Experience working with vendor-managed platforms and integrations