Business Analyst - Healthcare

Duties and Responsibilities:

• Serve as a resource in facilitating the gathering of business requirements and required test cases for configuration changes
• Work with key project stakeholders to formulate and communicate business requirements and scope of project
• Work with project stakeholders to translate their requirements into specifications technical staff can understand and also translate questions that technical staff has into a format the stakeholders can understand
• Perform all configuration changes within applicable software test environments
• Responsible for configuration, interface and application testing
• Develop and execute test cases and documentation to support configuration changes/updates/additions
• Work with stakeholders to validate test case results
• Coordinating and documenting for all configuration activity for change control and auditing
• Responsible for coordination of production turnover of all configuration work upon business owner sign off
• Serve as subject matter expert for root cause analysis and issue resolution
• Coordinate with the Application Support ticket tracking and bringing to resolution any software, configuration, EDI, ICES tickets that require updates to the test or production environments
• Perform business analysis duties for designated corporate projects and maintenance requests
• Oversee process development and documentation for any new or altered functionality or business process. This will also include facilitating an annual audit of actual business processes versus what is documented
• Identify potential areas of automation and aid in re-engineering the underlying business processes
• Recommend and maintain standards for development of business cases and their documentation

Qualifications

Required:

• Associates degree and/or years of experience and background to equate to the degree
• Minimum of two years of business analysis and system configuration experience; or similar demonstrated experience working with health care claim processing
• Prior experience in a Health Care organization or setting
• Benefit and contract configuration experience
• Experience with Health Rules or Facets
• Experience with SQL queries
• Excellent interpersonal skills, including the ability to work across the organization and to interact, influence and negotiate effectively
• Demonstrated ability to manage multiple priorities simultaneously in a deadline driven environment
• Proficient in MS Project, Excel, PowerPoint and Word
• Strong communication skills, both verbal and written

Preferred:

• Experience with Acuity software
• Experience with Optum CES (Claims Editing Software)
• Experience with Crystal reports/letters

Location: Centerdale, RI, US

Posted Date: 9/27/2024