Senior Business System Analyst

11 hours ago

Apply Now

Receive Emails with Similar Jobs

HealthEdge

WebsiteLinkedInAll Job Openings

Healthcare Insurance • SaaS • Fintech

HealthEdge is a company that specializes in providing advanced solutions for healthcare payers through its HealthRules Solutions Suite. This suite includes a comprehensive digital claims administration processing system, care management workflow solutions, and payment integrity solutions, which aim to enhance operational efficiency and improve quality of care for health plans. By leveraging integrated technology and automation, HealthEdge helps health plans eliminate data silos, increase payment accuracy, and elevate member experience, thereby transforming the healthcare landscape for better collaboration and accessibility.

1001 - 5000 employees

Founded 2005

⚕️ Healthcare Insurance

☁️ SaaS

💳 Fintech

📋 Description

• 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 analyzing the healthcare business requirements and translating them to functional and technical requirements. • Identify opportunities for automation, performance improvements, reusability. • Develop 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

• Bachelor’s degree or higher in business or technical field • 12+ years of relevant work experience in business analysis • 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) • 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 • Awareness to Agile tools and scrum methodologies • Communication skills with peers, customers, and partners including the ability to convey information effectively.

🏖️ Benefits

• HealthEdge commits to building an environment and culture that supports the diverse representation of our teams. • We aspire to have an inclusive workplace. • We aspire to be a place where all employees have the opportunity to belong, make an impact and deliver excellent software and services to our customers.