Job Summary

We are looking for a Business Analyst for our Healthcare client. This position is responsible for the development of business and functional requirements documentation and serves as a subject matter expert in an operational business area. He/she acts as a liaison to the operational business areas, coordinates on the requirements efforts of corporate projects. He/she might also be responsible for mapping business processes, actively participating in identifying current problems, and recommending business analysis solutions to operational issues. This role also requires knowledge of health plan operations including Medicare and Medicaid plans, claims processing, EDI transaction processing, enrollment, financial reconciliation, and IT systems knowledge. A successful candidate will possess leadership, communication and strong analytical skills and will be adept in business analysis.

Primary Responsibilities

Act as a key resource in gathering, coordinating, and documenting business requirements and test cases for corporate projects
Lead business analysis for project initiatives and ongoing process enhancements
Drive the development and documentation of processes for new or modified business functionalities
Analyze root causes and resolve complex operational issues
Understand operational processes within the business area
Identify and advocate for opportunities to bring value/improvements to the business area
Document key workflows within the assigned business department
Apply industry-specific expertise to recommend and coordinate the development, enhancement, and maintenance of a department's business systems, processes, and products
Combine industry expertise with a thorough understanding of information technology to develop innovative business solutions. Influence the strategic direction of the support department(s)
Manage large-scale project analyses, requirements, and change processes
Encourage and lead process improvement efforts and the training of peers and colleagues
Estimate resources and timelines for project deliverables
Develop innovative solutions to complex business and technology problems
Take on complex day-to-day assignments with a high degree of responsibility
Collaborate with stakeholders to define business requirements and project scope
Translate stakeholder needs into technical specifications and vice versa
Validate requirements with stakeholders and draft use cases for requirement documents
Identify potential areas of automation and aid in re-engineering underlying business processes
Assist in developing and maintaining standards for development of business processes and documentation

Education And Experience

Bachelor's degree or equivalent professional experience
Five (5)+ years of experience in a Managed Health Plan setting
Five (5)+ years of related business analysis/data analysis experience
Three (3)+ years of experience modeling business processes
Exceptional interpersonal abilities with a proven record of influencing and negotiating at all management levels
Demonstrated leadership with motivational and conflict resolution skills
Proficient in Microsoft Office Suite (Excel, PowerPoint, Word, Outlook)
Capable of engaging with a diverse stakeholder group including business users, developers, and senior management
Strong communication skills, both verbal and written
Exceptional time management and organizational capabilities
Autonomous initiative-taker with an unwavering work ethic
Strategic and analytical mindset, with expertise in quantitative analysis and operational planning
Experience in creating comprehensive business requirements and end-user documentation
Proven track record as an effective team leader and collaborator
Experience using and commitment to continuous quality improvement methods skills
Commitment to and experience with continuous quality improvement methodologies

Preferred

Extensive experience in an insurance, medical, or HMO environment using claims processing systems
Intermediate to Advanced proficiency in Microsoft Project and Visio
Experience in mentoring and training colleagues

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Sierra Solutions Group

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Healthcare Business Analyst