Business analyst

Machine Learning Technologies, LLC; Washington; In loco; USD 120.000 - 160.000; Tempo pieno

Descrizione del lavoro

Machine Learning Technologies, LLC seeks an experienced SME to coordinate Benefits operations and oversee payer enrollment, MSP rules, and eligibility workflows in Washington. You will drive governance and define future-state COB capabilities, collaborating with stakeholders across product and operations.

You will leverage AI tools to accelerate user stories, process documentation, and acceptance criteria while translating regulations into actionable platform requirements and ensuring

Competenze

• Current-state and future-state assessments
• Facilitate process modeling, gap analysis and impact assessments
• Develop BRDs, FRDs, user stories, use cases and acceptance criteria
• Translate requirements into epics and features
• Manage requirements traceability through SDLC
• Define MVP scope and release priorities
• Leverage Generative AI tools to accelerate user stories, process docs and criteria

Mansioni

• Act as SME for COB operations, payer enrollment processing, primacy determination, overlap management, and eligibility workflows
• Lead workshops with payer operations, business users, product owners and executives
• Analyze and rationalize COB business processes and workflows
• Interpret NAIC COB guidelines, MSP rules, Medicaid regulations, and state COB requirements
• Drive business rule governance and ensure traceability from regulations to platform implementation
• Define future-state business capabilities for modern COB ecosystems

Conoscenze

COB domain knowledge

Stakeholder facilitation

Process analysis

Regulatory interpretation

Business rule governance

Future-state design

Strumenti

ChatGPT

Claude

Copilot

Gemini

Descrizione del lavoro

• 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.