Enterprise Business Analyst – healthcare Payer || NYC, NY || Contract

 Enterprise Business Analyst – healthcare Payer

Location : NYC, NY – Remote

Duration : Contract to hire

Rate : $50/hr

Experience : 10 – 15 Years (Only USC)

Mandatory: Healthcare payer, Enrollment & Eligibility, Benefit Administration, Vendor Integrations, Claims Administration, Contribution Accounting, Billing & Payment,  Member, Provider  

About this Role:

We are seeking a passionate, results-oriented Sr. Business Analyst in the healthcare payer domain with Multi-employer/Benefit Administration of self-funded client who excels in client interactions, and can collaborate effectively stakeholders to analyze, define and manage requirements for client or product.  The ideal candidate will have worked in-depth in healthcare payer domain in Multi-employer/Benefit Administration (Hours & Eligibility mgmt, Contribution Acctg) or Health Plan Administration (Benefits & Claims Administration, Vendor integration, Portals) space. This person must possess a blend of business and technical savvy; strong communication skills to collaborate across internal and external stakeholders.

Job Responsibilities:

You will work with business and solution delivery owners to define and document requirements for the assigned products and services, as well as write user stories, acceptance criteria, feature description decks, process flows, manage traceability and UAT.
You will maintain a solid knowledge base of the functional and system capabilities of the various areas and products within the assigned product portfolio.
You will use applicable requirement methodology to analyze, define and document requirements and manage traceability. You will work with stakeholders and product teams to drive consensus on scope, design and implementation decisions.
Provides analysis and impact to user and business for changes to current functionalities and applies problem solving skills to meet business needs.
Develop and integrate requirement management to the delivery approach and schedule; you will also be responsible for product quality, project timeliness, and customer satisfaction.

Participate in the presentation of information to customer and internal business and or IT teams.
Creates business / product / third party vendor specifications for product integration and implementation.

 Essential Qualifications & Skills:

Minimum 5 years of experience as a business analyst in healthcare payer in onboarding new self-funded clients or implement product in Multi-employer Trust or Health Plan Administration
Experience in programs that focus on system integrations with 3rd party vendors is a must.

Expertise and experience in preparing High Level requirements, UseCases, 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 covering business & technology : Enrollment & Eligibility, Benefit Administration, Vendor Integrations, Claims Administration, Contribution Accounting, Billing & Payment,  Member, Provider and Employer facing portal/service
Strong analytical and problem solving skills; Ability to analyze problems and resolve issues through resolution quickly and methodically.
Proficient with Word, Excel, and PowerPoint, Visio
Knowledge of BA/ MS project Tools,  JIRA, MS Project, Excel, Visio
Self-motivated and detail-oriented
Flexibility to adapt to change and willing to learn and develop new skill sets as applicable

Bachelor’s degree or equivalent experience.  BA Certifications and or PMP a plus
 

Need writeup for below questions – Enterprise BA

1. How many years of experience do you have in working for a US Health Insurance Payer? Quote the details of most recent experience.

2. Have you worked for any US Health Insurance Third Party Administrator (TPA ) or any related projects? if so, quote the details.

3. How many years of experience do you have with any other US Healthcare Entity (apart from Payers or TPAs)? 

4. Have you worked on a new Health Plan or Product implementation for a Payer or a TPA? 

5. How many years of experience do you have in working on system integrations with 3rd party vendors? Quote the details of most recent experience. 

6. State the US Healthcare domains you have worked on. (e.g.: Eligibility, Claims, Provider, Benefits, Portals etc.). Tag the relevant experience from your resume for these domains.

7. State your expertise in US Health Insurance domain in a scale of 1-10, 10 being highest.

8. State your familiarity with EDI transactions (834, 835, 837 etc.). Tag the relevant experience from your resume.

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