COB Business Analyst - AI-Driven Process & Rules

Machine Learning Technologies, LLC; Washington; Presencial; USD 120.000 - 160.000; Jornada completa

Descripción de la vacante

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

Formación

• 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

Responsabilidades

• 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

Conocimientos

COB domain knowledge

Stakeholder facilitation

Process analysis

Regulatory interpretation

Business rule governance

Future-state design

Herramientas

ChatGPT

Claude

Copilot

Gemini

Descripción del empleo

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