Remote Healthcare Payer & Member Systems Analyst

E-Solutions, Inc.; United States; Remote; USD 95,000 - 125,000; Full time

Job summary

E-Solutions, Inc. is seeking a Senior Business Systems Analyst focusing on Healthcare Payer/Member Domain. Remote (USA) position requiring deep expertise in enrollment, eligibility, and benefits processing, with strong SQL and data-mapping skills to support data validation and API/EDI integrations.

The ideal candidate has 10 years of experience, excels in requirements gathering, and collaborates across business, operations, QA and IT teams in an Agile environment.

Qualifications

• Experience in Healthcare Payer / Member Domain.
• Strong knowledge of Enrollment, Eligibility and Benefits processes.
• Medicare, Medicaid, ACA Exchange familiarity.

Responsibilities

• Gather and document business/functional requirements.
• Translate requirements into user stories and system specifications.
• Support member enrollment, eligibility, and benefits processes.
• Conduct process mapping, data mapping, and gap analysis.
• Work with APIs, integrations, and EDI transactions.
• Perform SQL-based data validation and analysis.
• Support UAT, defect management, and business sign-offs.
• Collaborate with business, operations, QA, and technical teams.

Skills

Requirements gathering & analysis

BRD/FRD documentation

Functional specs & user stories

Process mapping & gap analysis

Data analysis

UAT support

Stakeholder management

Tools

SQL

Data mapping

API & interface analysis

EDI transactions

Job description

E-Solutions, Inc. is seeking a Senior Business Systems Analyst focusing on Healthcare Payer/Member Domain. Remote (USA) position requiring deep expertise in enrollment, eligibility, and benefits processing, with strong SQL and data-mapping skills to support data validation and API/EDI integrations.

The ideal candidate has 10 years of experience, excels in requirements gathering, and collaborates across business, operations, QA and IT teams in an Agile environment.