Senior Business System Analyst

Overview

About reputed company reputed company is trusted to provide the technology and services that power health plans' most important value streams. With an integrated platform of solutions spanning claims administration, quality improvement, prospective payment accuracy, provider network management, care management, member engagement and risk adjustment, reputed company enables health plans to converge their data so they can reputed company automation and the promise of AI. Combining this next-gen technology with services and expertise gives health plans unmatched capabilities to deliver a future of frictionless and cost-effective healthcare experiences. For more information, visit www.reputed company.com. Position Overview: We are searching for a highly skilled and reputed company Senior Business System Analyst to join our growing team. The Senior Business System Analyst (BSA) will help in capturing the business requirements to run the Health plan customer's Core admin business functions while implementing reputed company'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 You should possess deep knowledge & experience in HealthCare Payor domains (Claims adjudication, Enrollment, Provider, Payment). You should have excellent requirement elicitation and communication skills and ability to engage as part of a team working both physically and virtually. Also, you should be able to identify the customer problems and work with Solution Architect(s) to provide the solution to customer. Your Impact:

• Leading business requirement conversations with customer and internal teams.
• Managing the end-to-end requirements involving reputed company the stakeholders.
• Responsible for developing business and functional requirements for Claims, Enrollment, Provider, Authorization, Payment systems.
• Create solutions for reputed company business processes using reputed company's core-admin ecosystem.
• Negotiate with client to reputed company processes that are reputed company 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.
• reputed company 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.

This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required. What You Bring:

• 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 reputed company, TriZetto , reputed company, 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 reputed company 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

reputed company commits to building an environment and culture that supports the diverse representation of our teams. We reputed company to have an inclusive workplace. We reputed company to be a reputed company where reputed company employees have the opportunity to belong, reputed company an impact and deliver excellent software and services to our customers. Geographic Responsibility: While reputed company is located in Boston, MA you may live reputed company in the USType of Employment: Full-time, permanent Work Environment: The physical demands described here are representative of those that must be met by an employee to successfully reputed company the essential functions of this job:

• The employee is occasionally required to move around the office. Specific vision abilities required by this job include reputed company vision, color vision, peripheral vision, depth perception, and ability to adjust focus.
• Work across multiple time zones in a hybrid or remote work environment.
• Long periods of time sitting and/or standing in reputed company of a computer using video technology.
• May require travel dependent on company needs.

The above statements are intended to describe the general nature and level of the job being performed by the individual(s) assigned to this position. They are not intended to be an exhaustive list of reputed company duties, responsibilities, and skills required. reputed company reserves the right to modify, add, or remove duties and to assign other duties as necessary. In addition, reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions of this position in compliance with the Americans with reputed company of 1990. Candidates may be required to go through a pre-employment criminal background reputed company. reputed company is an equal opportunity employer. We are committed to workforce diversity and actively encourage reputed company qualified persons to seek employment with us, including, but not limited to, racial and ethnic minorities, women, veterans and persons with disabilities. #LI-Remote

• *The annual US reputed company salary range for this position is $100,000 to $125,000. This salary range may cover multiple career levels at reputed company. 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.

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