Business Analyst

6 days ago

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Brighton Health Plan Solutions

WebsiteLinkedInAll Job Openings

- employees

⚕️ Healthcare Insurance

☁️ SaaS

Description

• We are seeking a passionate, results-oriented Business Analyst in the healthcare payer domain. • The ideal candidate will have worked in-depth in healthcare payer domain in Multi-employer Trust (Hours & Eligibility management), Health Plan Administration (Benefits & Claims Administration, Vendor integration) space. • This person must possess a blend of business and technical savvy; strong communication skills to collaborate across internal and external stakeholders. • Serves as a liaison between the business programs community and the IT organization to provide technical solutions to meet project needs. • Critically evaluate information gathered from multiple sources; reconcile conflicts; abstract up from low-level information to a general understanding; and distinguish requests from underlying true needs. • Break down high level information gathered into details including sources of data, data types, users, user types, interface components, interface navigation needs, reporting needs, and administrative system needs. • Analyze and document client's business requirements and processes; use and promote industry standard analysis techniques, such as data flow modeling, use-case analysis, workflow analysis, business process mapping. • Translates high level business requirements into functional specifications for the IT organization and manages changes to such specifications. • Presenting concepts in a concise and focused manner, including narrative, process diagrams, role and accountability diagrams and business-focused story boards. • Forwards functional specifications to digital team members for design and solution development. • Work within timeline and resource constraints provided by the Project Manager. • Partner with stakeholders on requirements prioritization, solution approach and alternatives, and manage requirements changes to ensure developed solution conforms to business needs. • Proactively identify areas of potential business risk, on projects both within and outside of control, make recommendations related to mitigation and escalate as necessary. • Collaborate with designers, product managers, solution architects and developers to translate business requirements into innovative digital solutions. • Support User Experience (UX) design and partner with design leaders to create intuitive, user-centered interfaces that enhance the digital care, clinical, research and business experience. • Actively participate in design, development and testing of products and solution lifecycles including development of wireframes, prototypes and user-testing. • Produces business design document based on product and solution requirements. • Support Quality Assurance (QA) Testing by developing test plans, test cases and acceptance criteria to validate digital solutions against business requirements and regulatory standards. • Participate in QA testing activities, identify defects, and collaborate with teams to ensure timely resolution and delivery of high-quality products and solutions. • Performs other related duties as assigned or requested.

Requirements

• A bachelor’s degree. BA Certifications and or PMP is a plus. • 4+ years of BA experience in onboarding new self-funded clients or implement product in Multi-employer Trust or Health Plan Administration. • Good working knowledge of Eligibility and Enrollments, Administration of Plans, Benefits, claims, accumulators, Provider Finder. • Experience with SFTP, EDI X12 transactions 834, 837, 270/1 is a plus. • Ability to adapt to a fast pace, changing environment and to handle changing priorities and deadlines. • Skilled at persuasive written and verbal communications that drive action or set strategic direction. • Proficient in Microsoft Office including Outlook, Excel, Visio, PowerPoint and Word. • Knowledge of BA/ MS project Tools, JIRA, MS Project. • Able to manage large scale initiatives. • Skilled at large JAD type sessions and interviews and be able to document SMART requirements for consumption by technical teams. • Need to have a commanding the room type personality to drive their work and facilitate conversations. • Ability to manage multiple stakeholders from different business areas both technical and business. • Familiar with assumptions, dependencies, defining what is in and out of scope.