Sr. Business Analyst

About the role

The Business System Analyst (BSA) will support the implementation of UST HealthProof's core-admin ecosystem, focusing on claims adjudication, enrollment, provider, authorization, and payment systems. The role involves collaborating with customers, internal teams, and offshore staff to ensure that the final product meets project objectives and client expectations.

Responsibilities

• Leading business requirement conversations with customer and internal teams
• Managing the end-to-end requirements involving all stakeholders
• 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 clients 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 analyzing the healthcare business requirements and translating them to functional and technical requirements
• 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
• 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

• 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
• Geographic Responsibility: Remote, US
• Type of Employment: Full-time, permanent
• Travel%: up to 25%
• FLSA Classification (USA Only): Exempt

Benefits

UST HealthProof offers competitive benefits including health, dental, and vision insurance, retirement savings options, paid time off, and a flexible work environment.

Pay

The annual US base salary range for this position is $120,000 to $140,000. This salary range may cover multiple career levels at HealthEdge. Final compensation will be determined during the interview process and is based on a combination of factors including, but not limited to, your skills, experience, qualifications and education.

Schedule

The role is full-time, permanent, and requires up to 25% travel. Work is conducted remotely within the United States.