Business analyst

Ethereum Technologies LLC; Washington; In loco; USD 90.000 - 150.000; Tempo pieno

Descrizione del lavoro

Ethereum Technologies is seeking a Business Analyst with COB expertise to serve as the subject matter expert for Coordination of Benefits operations, payer enrollment processing, primacy determination, and eligibility workflows. The role includes leading workshops with stakeholders and shaping future COB capabilities.

The ideal candidate will analyze current processes, document regulatory guidelines, and drive governance to ensure traceability from rules to the COB platform implementation.

Competenze

• Current-state and future-state assessments.
• Facilitate business process modeling and impact assessments.
• Translate complex requirements into epics and user stories.
• Requirements traceability throughout the SDLC.
• Define MVP scope and release priorities.

Mansioni

• Act as the SME for Coordination of Benefits operations, payer enrollment processing, primacy determination, overlap management, and member eligibility workflows.
• Lead workshops with payer operations, business users, product owners, and executive stakeholders.
• Analyze and rationalize existing COB business processes and operational workflows.
• Interpret and document NAIC COB guidelines, MSP rules, Medicaid regulations, and state COB requirements.
• Drive governance and traceability from regulations to platform implementation.
• Define future-state business capabilities for modernized COB ecosystems.

Strumenti

ChatGPT

Claude

Copilot

Gemini

Descrizione del lavoro

US Citizen, Green Card, H-1B, OPT-EAD, CPT, Other

• Act as the SME for Coordination of Benefits operations, payer enrollment processing, primacy determination, overlap management, and member eligibility workflows.
• Lead workshops with payer operations, business users, product owners, and executive stakeholders.
• Analyze and rationalize existing COB business processes and operational workflows.
• Interpret and document NAIC COB guidelines, Medicare Secondary Payer (MSP) rules, Medicaid regulations, and state-specific COB requirements.
• Drive business rule governance and establish traceability from regulations to platform implementation.
• Define future-state business capabilities for modernized COB ecosystems

Requirements & AI-assisted Business Analysis :

• Conduct current-state and future-state assessments.
• Facilitate business process modeling, gap analysis, and impact assessments.
• Develop BRDs, FRDs, user stories, use cases, process flows, and acceptance criteria.
• Translate complex business requirements into epics, features, and detailed user stories.
• Manage requirements traceability throughout the SDLC.
• Define MVP scope and release-level business priorities.
• Leverage Generative AI platforms (ChatGPT, Claude, Copilot, Gemini, etc.) to accelerate:
• User story generation
• Process documentation
• Acceptance criteria creation
• Business rule extraction
• Utilize AI-assisted analysis techniques to reverse engineer legacy COB applications and uncover hidden business logic.

We are an equal opportunity employer. All aspects of employment including the decision to hire, promote, discipline, or discharge, will be based on merit, competence, performance, and business needs. We do not discriminate on the basis of race, color, religion, marital status, age, national origin, ancestry, physical or mental disability, medical condition, pregnancy, genetic information, gender, sexual orientation, gender identity or expression, national origin, citizenship/ immigration status, veteran status, or any other status protected under federal, state, or local law.