Job description

Title: Sr. Healthcare Payer Business Analyst
Location: 100% Remote Anywhere
Type: Direct hire
Salary: Up to $145,000, depending on experience
Sponsorship: No

About the Role
We are seeking a passionate, results-oriented Senior Enterprise Business Analyst who can collaborate effectively with internal and external stakeholders to analyze, define and manage requirements to launch new product & services. The ideal candidate will have worked in-depth for top payers across one or more domains (Enrollment & Benefit Administration, Claims processing & Reimbursements, Member & Provider Portals/Service, Clinical & Care management, Funding & Billing, Reporting). This person must possess a blend of business and technical savvy; strong communication skills to collaborate across internal and external stakeholders.

Note:
Please avoid EMR/EHR resumes unless they have the below.

Please think through sending Medicaid/Medicare resumes unless they have the below or perhaps did it through Blue Cross or one of the BUCAs.

Reminder, we need a client facing Sr. BA with 6 years of Commercial or TPA experience, Full time.

Essential Qualifications:

Client Facing experience (not backend), ability to lead Requirements sessions in the healthcare payer industry.
Minimum 2-3 years of experience as a business analyst in healthcare payer industry - Commerical/TPA is a must
Major program and project involvement
Expertise and experience in preparing High Level requirements, Use Cases, Business Requirement Documents, Functional specifications, Test strategy & cases and Traceability matrix.
Proven ability to map business process and workflows, conducting gap analysis and documenting requirements, ensuring requirements are developed and tested.
Excellent verbal/written communication skills; comfortable leading business and technology teams within the organization to translate business issues & requirements into technical solutions.
Healthcare Insurance Payer in one of more of the following areas: Claims Administration, Enrollment & Eligibility, Benefit Administration, Contribution Accounting, Billing & Payment, Member, Provider and Employer facing portal/service.

Required profile