Healthcare Data & Payer Systems Analyst (Member 360)

BBI; Pittsburgh (Allegheny County); On-site; USD 90,000 - 120,000; Full time

Job summary

BBI is seeking a Healthcare Business Systems Analyst to support the design, analysis, and delivery of integration and member-intelligence solutions for health payer programs.

This role sits at the intersection of business analysis, enterprise integration, cloud platforms, and health-plan operations—helping connect eligibility, claims, clinical, pharmacy, and social-need data to enable holistic member insights.

Qualifications

• Bachelor's degree in a relevant field and at least 4 years of healthcare business systems analysis experience.
• Experience documenting requirements, user stories, workflows, data mappings, and acceptance criteria.
• Proficient with healthcare payer systems and data exchanges, including HIPAA considerations.
• Ability to translate business needs into clear, delivery-ready requirements.
• Familiarity with integration patterns and cloud platforms used in health plans.

Responsibilities

• Elicit, analyze, and document business requirements, functional specs, user stories, and data mapping needs.
• Support Member 360 and Whole Person Insights initiatives for care management and population health.
• Analyze payer processes across eligibility, enrollment, claims, and member engagement domains.
• Translate business workflows into integration requirements for on-premises and cloud environments.
• Develop test scenarios and validate rules during SIT/UAT and production validation.
• Ensure HIPAA and payer data-handling compliance in requirements and designs.
• Act as bridge between business stakeholders and technical delivery teams.

Skills

Stakeholder communication

Analytical thinking

Business requirements gathering

Documentation

Facilitation

Education

Bachelor's degree in computer science, engineering, health informatics, business, or related field

Tools

Java/JEE

Spring

APIs

ServiceNow

AWS/Azure/Google Cloud

Job description

BBI is seeking a Healthcare Business Systems Analyst to support the design, analysis, and delivery of integration and member-intelligence solutions for health payer programs.

This role sits at the intersection of business analysis, enterprise integration, cloud platforms, and health-plan operations—helping connect eligibility, claims, clinical, pharmacy, and social-need data to enable holistic member insights.