Data Management Business Systems Analyst Senior

Role Overview

The Business Systems Analyst Senior – Data will provide techno-functional subject matter expertise for healthcare payor data initiatives, including claims, membership, provider, clinical, care management, interoperability, and population health data domains. This role will lead requirements definition, data analysis, functional specifications, source-to-target mapping, data quality validation, and cross-functional delivery across data Lakehouse and cloud data platforms.

Work Arrangement

This is a hybrid, office based position working in our Ellis Preserve office located in Newtown Square, PA Office days are Tuesday, Wednesday, & Thursday; Remote days and Monday & Friday.

Responsibilities

• Provides ongoing support for an assigned set of systems, technologies, and capabilities, including data mapping, configuration, and queries.
• Serves as a SME for all or most components of a major system, understanding how information is used and how systems may need to adapt to changes in business processes.
• Leads the requirements management process for change requests, enhancements, and projects, including documenting requirements and changes such as user stories, as appropriate.
• Leads data-focused requirements management across the SDLC and Agile lifecycle, including intake, estimation, design, development support, testing, deployment, and change management.
• Acts as a liaison between the business and IS technical solutions/support groups, leading the definition of functional requirements, explaining changes to business processes, and communicating status.
• Serves as an expert advisor to the IS team to ensure delivery meets business needs.
• Researches various information and data sources and presents complex information, data, and recommendations to leadership.
• Creates and maintains functional specifications, source-to-target mappings, traceability documentation, business process maps, and other standard project deliverables such as RTM and FMEA, as applicable.
• Performs advanced SQL-based data analysis, profiling, validation, and root cause analysis across healthcare payor datasets, including claims, membership, provider, clinical, EDI, and care management data.
• Promotes end-to-end data delivery using platforms and tools such as Azure Data Factory, Databricks, Snowflake, Oracle, SQL, and BI/reporting tools.
• Establishes and monitors data quality SLAs, metrics, dashboards, and issue-resolution processes for business-critical datasets in partnership with data governance and business stakeholders.
• Validates reporting-layer and analytics outputs by collaborating with Power BI, Tableau, data science, and analytics teams to ensure data accuracy, completeness, consistency, and business usability.
• Guides and educates more junior team members on technical knowledge.

Qualifications

• At least eight (8)+ years of experience in business systems analysis, data analysis, project delivery, process re-engineering, or related business/technology roles; healthcare payor experience strongly preferred.
• At least five (5)+ years of experience in healthcare, preferably Medicaid, Medicare, managed care, payer operations, or healthcare data platforms.
• Strong SQL skills with the ability to create, interpret, and validate complex queries for data analysis, profiling, reconciliation, and business rule validation.
• Experience with data platforms such as Azure Databricks, Delta Lake, Delta Live Tables, Unity Catalog, Azure Data Factory, Snowflake, Oracle, Informatica, IBM DataStage, Kafka, Pyper, or Python.
• Knowledge of data governance, data quality frameworks, PII compliance, HIPAA, privacy standards, and data standardization practices.
• Experience with healthcare payor systems and datasets such as FACETS, claims, membership, provider, clinical, EDI transactions, care management, population health, HEDIS, CMS interoperability, or related payer data domains.
• Bachelor’s degree in computer science or equivalent years of relevant work experience.

Skills

• Advanced expertise and knowledge of work processes for assigned business areas, including how systems are used, how information flows, how decisions are made, future roadmaps, and how systems may need to adapt to business changes.
• Strong analytical, communication, facilitation, leadership, and stakeholder management skills, with the ability to work independently, manage multiple priorities, resolve competing needs, and guide junior team members.
• Understanding of the business impact of different solutions and can assess and communicate tradeoffs between business needs, technology requirements, costs, and risk.
• Understanding of the general competitive landscape from a business and technology perspective.

Benefits

Comprehensive benefits package includes flexible work solutions, competitive pay, paid time off, health insurance coverage, 401(k), tuition reimbursement, and more. AmeriHealth Caritas is committed to building healthier communities through innovative health care solutions.