Government Programs, Senior Business Analyst

Judi Health, LLC; Charlotte, Denver, New York (NC, CO, NY); On-site; USD 92,000 - 116,000; Full time

Job summary

Judi Health, LLC is seeking a Senior Business Analyst to support gathering and documenting business and reporting requirements aligned with state and federal guidelines. The role analyzes complex problems, creates specification documents for processes, reports, data extracts, and analyses, and supports QA and validation activities.

You will collaborate with compliance, product, sales, marketing, and operations teams to drive improvements.

Qualifications

• Bachelor’s degree or equivalent experience in a related field.
• 3+ years of healthcare data experience.
• 3+ years of business process analysis, preferably in healthcare.
• 3+ years of experience with Government Exchange programs.
• Knowledge of SQL, Excel, and flow-charting tools.
• Experience with implementation/project management.
• Experience working with cross-functional teams.
• Comfort in a fast-paced, growing environment.

Responsibilities

• Monitor changes in existing business processes and update documentation accordingly.
• Identify opportunities for process development and improvements.
• Gather, analyze, and manage stakeholder requirements from intake to delivery.
• Develop subject matter expertise on processes supported by the team.
• Perform root-cause analysis of data and process issues with stakeholders.
• Create and maintain comprehensive process specifications for cross-functional teams.

Skills

SQL

Excel

Flowcharts

Project management

Cross-functional teams

Agile / CSPO

Education

Bachelor's degree or 3+ years relevant experience

Job description

Government Programs, Senior Business Analyst

Judi Health is a health technology company providing benefit administration solutions to employers, unions, health plans, and government entities. Judi Health replaces fragmented, outdated systems with the industry's first Unified Claims Processing™ architecture, seamlessly consolidating pharmacy and medical benefit administration on a single, secure platform. By delivering true price transparency, eliminating unnecessary middleman fees, and leveraging advanced AI-powered care delivery, Judi Health helps clients achieve unprecedented operational efficiency and service levels. At Judi Health, we're deploying the infrastructure our country needs to deliver the healthcare we all deserve. We are the intelligence platform powering benefits plans for millions of Americans and proudly leading the next generation of care. To learn more, visit www.judi.health.

Hybrid (Local to New York, NY, Denver, CO or Charlotte, NC)

Position Summary: The Senior Business Analyst supports the gathering and documentation of business and reporting requirements that align with state and federal guidelines. This individual analyzes complex problems and issues using available information from both internal and external sources. Other responsibilities include creating specification documents for business processes, reports, data extracts, and analyses based on business needs, as well as supporting quality assurance and validation activities. The Senior Business Analyst identifies and interprets trends in datasets to find possible outliers or patterns that can be used to drive process improvements and collaborates with internal and external cross-functional teams (compliance, product, sales, marketing, underwriting, implementation, client services, and clinical operations) to design, refine, validate, automate, and maintain operational capabilities.

Position Responsibilities:

• Monitors for changes in existing business processes and updates documentation accordingly - Finds new opportunities for process developments and improvements
• Finds new opportunities for process developments and improvements
• Intake, analyze, document, and manage requests and requirements from stakeholders
• Proactively reviews business processes and data to develop subject matter expertise of processes supported by our team
• Drives root-cause-analysis and resolution of data and and processes issues/errors by partnering with key stakeholders
• Drives departmental efficiency by designing, documenting, and maintaining comprehensive process specifications for cross-functional teams within the government operations department.
• Analyzes business workflows and system needs to support operational process development, conversions, migrations, and regulatory requirements
• Prepares and maintains end-user documentation, requirements documentation, and training materials as needed
• Develop and test scenarios, validating results based on documented business and functional requirements, and tracking identified issues through resolution
• Partner with stakeholders from business units, IT, operations, finance, and project teams to gather, document, and translate business requirements into actionable solutions for quality assurance and validation
• Develop and set up performance metrics for stakeholder distribution
• Support encounter and PDE (Prescription Drug Events) submission process by analyzing complex data issues using data from internal and external sources
• Improve encounter and PDE submission processes by reviewing and synthesizing state and federal recourses, consolidating into comprehensive business requirements documents
• Recommend and drive continuous improvement initiatives across pharmacy claims reversal and reprocessing. Optimize organization-wide service delivery by auditing and refining workflows, business requirements, standard operating procedures (SOPs), internal controls, and quality assurance activities.
• Performs root-cause analysis of pharmacy claims reversal and reprocessing (R&R) issues; documents findings, develops recommendations, and supports issue resolution based on data and industry knowledge

Required Qualifications:

• Bachelor’s degree or equivalent
• 3+ years of healthcare data experience
• 3+ years of business process analysis, preferably in healthcare
• 3+ years of experience with Government Exchange programs
• Demonstrable knowledge of SQL, Excel, and flow-charting tools
• Experience with implementation/project management
• Experience working with cross-functional teams
• Extremely flexible, highly organized, excellent communication and able to shift priorities easily
• Attention to detail & commitment to delivering high-quality work product
• Comfort or experience in a fast-paced, growing environment
• Intellectual and professional curiosity
• Familiarity with the agile framework/Certified Scrum Product Owner preferred
• Bachelor’s degree in Business Administration, Data Analytics, Computer Science or 3+ years of relevant experience

New York, NY Salary Range

$110,800 - $138,500 USD

Denver, CO Salary Range

$101,600 - $127,000 USD

Charlotte, NC Salary Range

$92,400 - $115,500 USD

All employees are responsible for adherence to the Judi Health Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.

We provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

U.S. Standard Demographic Questions

We invite applicants to share their demographic background. If you choose to complete this survey, your responses may be used to identify areas of improvement in our hiring process.

Voluntary Self-Identification

For government reporting purposes, we ask candidates to respond to the below self-identification survey.Completion of the form is entirely voluntary. Whatever your decision, it will not be considered in the hiringprocess or thereafter. Any information that you do provide will be recorded and maintained in aconfidential file.

As set forth in Judi Health's Equal Employment Opportunity policy,we do not discriminate on the basis of any protected group status under any applicable law.

If you believe you belong to any of the categories of protected veterans listed below, please indicate by making the appropriate selection.As a government contractor subject to the Vietnam Era Veterans Readjustment Assistance Act (VEVRAA), we request this information in order to measurethe effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA. Classification of protected categoriesis as follows:

A "disabled veteran" is one of the following: a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service-connected disability.

A "recently separated veteran" means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service.

An "active duty wartime or campaign badge veteran" means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.

An "Armed forces service medal veteran" means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.