Offer summary

Qualifications:

Minimum 6-7 years of experience as a business analyst in the healthcare payer insurance industry, specifically with Commercial TPA., Experience with ASO (Administrative Services Only) and multi-employer environments is essential., Strong communication skills to effectively collaborate with internal and external stakeholders., Expertise in preparing business requirement documents, use cases, and conducting gap analysis..

Key responsibilities:

Collaborate with stakeholders to analyze, define, and manage requirements for new products and services.

Lead requirements sessions and ensure effective communication across business and technology teams.

Map business processes and workflows, conducting gap analysis and documenting requirements.

Prepare high-level requirements, functional specifications, and test strategies to ensure successful project outcomes.

Job description

Title: Sr. Healthcare Payer Business Analyst
Location: 100% Remote
Hours: 9:00 – 6:00 Eastern
Type: Contract to Hire
Duration: 12 months
Laptop: Provided
Rate: up to $70/hr, depending on experience. Conversion salary up to around $135K

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.

Essential Qualifications

Client Facing acumen, ability to lead Requirements sessions in the healthcare payer industry.
Minimum 6-7 years of experience as a business analyst in the healthcare payer insurance industry – Commerical TPA is a must
Multi-employer experience
ASO (Administrative Services Only) experience (self-funds its employee health benefit plan but outsources administrative services to a third-party provider, typically an insurance company).
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