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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