IT Business Consultant

HCSC Group; Nashville (TN); On-site; USD 70,000 - 126,000; Full time

Job summary

HCSC is seeking an IT Business Consultant to ensure quality, accuracy, and regulatory compliance of Medicare operations solutions. You will partner with business stakeholders, product teams, operations, and technology to validate requirements, design test scenarios, and execute end-to-end testing that meets CMS guidelines.

The role demands strong analytical skills, healthcare knowledge, and clear communication of testing results to stakeholders, delivering high-quality outcomes for members,

Qualifications

• Bachelor degree or 7 years’ experience in health care/business analysis or related field.
• Experience in testing, QA, UAT, and validation of business processes.
• Healthcare payer experience, preferably Medicare/Medicaid.
• Excellent written and verbal communication for diverse stakeholders.
• Experience with multiple departments and priority changes.

Responsibilities

• Validate business requirements and design comprehensive test scenarios.
• Lead end-to-end testing and report defects and risk impacts.
• Collaborate with business, product, operations and technology teams.
• Ensure solutions meet CMS and regulatory requirements.

Skills

Business Analysis

QA & UAT

Agile & Scrum

Stakeholder Management

SQL

Education

Bachelor Degree or equivalent experience

Tools

Jira

Confluence

qTest

TriZetto Facets / EAM

Job description

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

The IT Business Consultant is responsible for ensuring the quality, accuracy, and regulatory compliance of business and technology solutions that support Medicare operations. This role partners closely with business stakeholders, product teams, operations, and technology organizations to validate business requirements, design comprehensive test scenarios, execute end-to-end testing activities, and ensure solutions meet organizational and CMS requirements. The candidate will serve as a key liaison between business and technology teams, ensuring that system enhancements and strategic initiatives are thoroughly tested and delivered with the highest level of quality. Success in this role requires strong analytical skills, attention to detail, the ability to navigate complex healthcare environments, and a commitment to delivering exceptional outcomes for members, providers, and business partners.

Required Job Qualifications:

• Bachelor Degree and 3 years’ experience OR 7 years’ experience in business analysis, process improvement, strategic planning, research, project management, product administration, product operations or relevant health care industry experience
• Experience in business testing, quality assurance, User Acceptance Testing (UAT), and business process validation.
• Experience supporting healthcare-related lines of business, preferably within Medicare, Medicare Advantage, Medicaid, or Health Insurance environments. Knowledge of strategic planning techniques and industry trends
• Excellent verbal and written communication and organization skills, including the ability to clearly communicate testing results, defects, and business impacts to a variety of stakeholders.
• Experience with changing assignments and priorities
• Experience interacting with personnel of multiple departments and at various levels in the organization
• Project management skills, including strong organization, prioritization and problem solving skills; strong oral, verbal and interpersonal communication skills; ability to accept direction and feedback
• Strong analytical and problem-solving skills with the ability to identify risks, evaluate impacts and recommend solutions

Preferred Required Job Qualifications:

• Demonstrated experience developing test strategies, test scenarios, test cases, and executing end-to-end business process testing across functional areas such as Provider, Claims, Membership, Enrollment, Benefits, Fulfillment, and Digital platforms.
• Experience validating end-to-end business processes and system capabilities across healthcare operational workflows.
• Proven ability to collaborate effectively with cross-functional teams, including business stakeholders, delivery teams, product owners, technology partners, and external vendors.
• Experience working in Agile and Scrum delivery environments, including participation in sprint planning, backlog refinement, testing, and release activities.
• Highly self-motivated and adaptable, with the ability to manage competing priorities and deliver results in a fast-paced environment.
• Exceptional attention to detail and commitment to delivering high-quality outcomes.
• Experience in business testing, quality assurance, quality engineering, and user acceptance testing (UAT).
• Experience within the healthcare industry, preferably supporting Medicare, Medicare Advantage, Medicaid, or commercial health insurance products.
• Demonstrated knowledge of complex, high-volume healthcare claims processing environments, including claims adjudication, enrollment, provider, and member functions.
• Strong understanding of healthcare business processes and the ability to validate end-to-end operational and system workflows.
• Working knowledge of data modeling, database concepts, and SQL for data validation, analysis, and troubleshooting.
• Experience with TriZetto healthcare core administration platforms such as Facets, EAM, etc.
• Proficiency with Agile delivery and testing tools, including Jira, Confluence, and qTest.
• Experience supporting large-scale healthcare transformation, regulatory, and compliance-driven initiatives.
• Ability to analyze complex business requirements, identify risks, and recommend effective testing strategies.
• Strong stakeholder management, collaboration, and communication skills with the ability to work effectively across business, operations, and technology teams.

Sponsorship is not available including if you are currently on OPT.

Compensation: $69,800.00 - $125,900.00

Exact compensation may vary based on skills, experience, and location

HCSC Employment Statement:

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. We are a drug‑free and smoke‑free workplace. Employment may be contingent upon successful completion of drug screening in accordance with applicable law.

To learn more about available benefits, please click https://careers.hcsc.com/totalrewards