Note: The job is a remote job and is open to candidates in USA. UST HealthProof is a fast-paced company focused on transforming health insurance through innovative solutions. The Senior Business Analyst will capture business requirements, collaborate with various stakeholders, and improve operational efficiency by implementing core-admin solutions.
Responsibilities
- 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 analysing 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
Skills
- 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
- Bachelor's degree or higher in business or technical field
- 10+ years of relevant work experience in business analysis
- Experience working HealthEdge applications like HealthRules Payor or GuidingCare is a plus
- Understanding of SQL, XSDs is a plus
Company Overview