Business Analyst

Independence Blue Cross; Philadelphia (Philadelphia County); On-site; USD 65,000 - 90,000; Full time

Job summary

Talentify is seeking a Business Analyst to support appeals operations by analyzing performance data, identifying root causes, and ensuring regulatory compliance. The role collaborates with internal teams and vendor partners to improve accuracy, turnaround times, and overall service performance.

The position operates within a Hybrid model (office 3 days a week; remote 2 days). Candidate will work in the Tri-State Area (DE/NJ/PA).

Qualifications

• Bachelor's degree required in a relevant field
• 2-5 years of experience in business analysis, operations, or healthcare environment
• Strong analytical skills with experience in performance metrics
• Advanced Excel skills and experience developing reports
• Strong written and verbal communication skills
• Proven problem-solving and root cause analysis experience

Responsibilities

• Assist Vendor Onboarding and Offboarding activities through the contract lifecycle
• Analyze Appeals performance (TAT, quality, overturn rate, inventory, productivity) to identify trends and risks
• Monitor appeals inventory and case aging to support timely and compliant processing
• Conduct root cause analysis on quality defects, overturns, and documentation gaps
• Support vendor oversight, including SLA monitoring and issue resolution tracking
• Develop reporting and executive-ready summaries for leadership and business reviews
• Support Monthly Business Reviews and vendor governance routines
• Identify and support process improvements to enhance accuracy, efficiency, and compliance
• Partner with Operations, QA, Compliance, and vendor teams to drive performance outcomes

Skills

Analytical skills

Excel

Communication

Problem solving

Performance metrics

Reporting

Education

Bachelor's degree in Business/Healthcare Administration

Tools

Power BI

Tableau

SQL

Job description

The Business Analyst supports vendor performance management for Appeals operations by analyzing performance data, identifying root causes of quality and compliance gaps, and supporting governance routines. This role partners with internal teams and vendor partners to improve appeals accuracy, turnaround time, and overall service performance while ensuring adherence to regulatory and contractual requirements.

Primary Responsibilities

• Assist Vendor Onboarding and Offboarding activities through the contract lifecycle
• Analyze Appeals performance (TAT, quality, overturn rate, inventory, productivity) to identify trends and risks
• Monitor appeals inventory and case aging to support timely and compliant processing
• Conduct root cause analysis on quality defects, overturns, and documentation gaps
• Support vendor oversight, including SLA monitoring and issue resolution tracking
• Develop reporting and executive-ready summaries for leadership and business reviews
• Support Monthly Business Reviews and vendor governance routines
• Identify and support process improvements to enhance accuracy, efficiency, and compliance
• Partner with Operations, QA, Compliance, and vendor teams to drive performance outcomes

Minimum Qualifications

• Bachelor's degree in Business, Healthcare Administration, or related field
• 2-5 years of experience in business analysis, operations, or healthcare environment
• Strong analytical skills and experience working with performance metrics
• Advanced Excel skills and experience developing reports
• Strong written and verbal communication skills
• Proven problem-solving and root cause analysis experience

Preferred Qualifications

• Experience in healthcare appeals or grievance operations
• Familiarity with compliance/regulatory requirements (e.g., CMS, NCQA)
• Experience supporting vendor/offshore operations or BPO environments
• Knowledge of performance metrics (TAT, overturn rate, quality, inventory)
• Experience with reporting tools (Power BI, Tableau, SQL)
• Knowledge of process improvement methodologies (Lean, Six Sigma)

Independence has implemented a "Hybrid" model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the "Hybrid" model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania.

IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.

Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.