Business System Analyst (BSA)

Job Description

Business System Analyst (BSA)

Manager I – Consulting

Who We Are

UST HealthProof is a dynamic company with a mission to lower the cost of care and deliver the future of healthcare. Our consumer-centric approach gives our health plan customers a modern infrastructure and reduced administrative costs, helping to drive better business results for our customers — and better outcomes for our communities.

We achieve this mission together through teamwork, communication, collaboration, and focus. Our employees are our greatest assets, and we invite you to apply to be a part of our journey toward making a difference in healthcare in the United States. **

You Are**

The Business System Analyst (BSA) will help in capturing the business requirements to run the Health plan customer’s Core admin business functions while implementing UST HealthProof’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 The Candidate should possess deep knowledge & experience in HealthCare Payor domains (Claims adjudication, Enrollment, Provider, Payment). He / She should have excellent requirement elicitation and communication skills and the ability to engage as part of a team working both physically and virtually. Also, he/she should be able to identify the customer's problems and work with the Solution Architect(s) to provide the solution to the customer. **

The Opportunity**

• Leading business requirement conversations with customers 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, and 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 finished 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, and 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 a timely manner with the Customer to complete the requirement gathering to meet the project plan dates.
• Must work with Offshore Business Analysts to elaborate user stories
• Conduct Requirements walk through with the customer and internal/external stakeholders
• Collaborate with the development team & QA team to ensure the finished product meets project objectives and client expectations.
• Contribute towards sprint planning, retrospective, go-live/no go-live evaluation meetings.
• Conduct a 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 Need**

• Knowledgeable in the Healthcare insurance domain (Medicare, Medicare Advantage, Medicaid, ACA, or Commercial).
• Exposure to healthcare ecosystems 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 of Agile tools and scrum methodologies.
• Communication skills with peers, customers, and partners including the ability to convey information effectively.
• Experience in analyzing business requirements and translating/mapping them to technical requirements in EDI technology by analyzing 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 with HealthEdge applications like HealthRules Payor or GuidingCare is a plus.
• Understanding of SQL and XSDs is a plus.
• Bachelor’s degree or higher in business or technical field, 12+ years of relevant work experience in business analysis

Compensation can differ depending on factors including but not limited to the specific office location, role, skill set, education, and level of experience. As required by local law, UST Healthproof provides a reasonable range of compensation for roles that may be hired in California, Colorado, New York, or Washington as set forth below. **

Role Location: Remote

Compensation Range:** $120,000-$140,000

Our full-time, regular associates are eligible for 401K matching, and vacation accrual and are covered from day 1 for paid sick time, healthcare, dental, vision, life, and disability insurance benefits. **

What We Believe**

We’re proud to embrace the same values that have shaped UST HealthProof since the beginning. Since day one, we’ve been building enduring relationships and a culture of integrity. And today, it's those same values that are inspiring us to encourage innovation from everyone, to champion diversity and inclusion, and to place people at the center of everything we do. **

Humility**

We will listen, learn, be empathetic, and help selflessly in our interactions with everyone. **

Humanity**

Through business, we will better the lives of those less fortunate than ourselves. **

Integrity**

We honor our commitments and act with responsibility in all our relationships. **

Equal Employment Opportunity Statement**

UST HealthProof is an Equal Opportunity Employer.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

UST HealthProof reserves the right to periodically redefine your roles and responsibilities based on the requirements of the organization and/or your performance.

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