Remote Senior Healthcare Analyst: Claims & Appeals

Eliassen Group; Montpelier (VT); Remote; USD 48,000 - 55,000; Full time

Job summary

Eliassen Group is seeking a Sr Business Analyst for a remote, contract role focused on healthcare plan initiatives. The analyst will elicit, analyze, document, and manage requirements for complex business problems, partnering with cross-functional teams, ensuring traceability, and supporting training and post-implementation reviews.

Responsibilities include developing requirements strategies, maintaining scope, facilitating communication with stakeholders, and driving business readiness.

Qualifications

• 5+ years of related business analysis experience; 7+ if no degree.
• Healthcare, health plan, insurance, or pharmaceutical domain experience.
• Hands-on exposure to medical appeals, claims, and large plan implementations.
• Strong communication and stakeholder management in high-pressure settings.
• Proficiency with data flow modeling, use-case/workflow analysis, and ROI modeling.

Responsibilities

• Elicit, analyze, document, and manage requirements for complex initiatives.
• Develop requirements approaches and management plans aligned to project plans.
• Communicate and validate requirements with stakeholders and SMEs.
• Maintain solution scope and traceability throughout the lifecycle.
• Drive business readiness and change communication for technology/process changes.
• Coordinate training to ensure effective implementations and outcomes.
• Develop specs for system/process changes and coordinate cross-functional work.
• Design post-implementation audits and collect customer feedback.
• Analyze workflows, design and test solutions, assess organizational impact.
• Manage requirement change requests and maintain documentation.
• Develop and maintain reporting tools to measure performance and data integrity.
• Present results to business stakeholders and leadership.
• Identify risks, mitigation, and escalation as needed.
• Build and support vendor relationships and assist with training.
• Provide oversight and peer reviews for less experienced analysts.

Skills

Stakeholder management

Requirements elicitation

Business analysis

Communication

Education

Bachelor's degree

Job description

Eliassen Group is seeking a Sr Business Analyst for a remote, contract role focused on healthcare plan initiatives. The analyst will elicit, analyze, document, and manage requirements for complex business problems, partnering with cross-functional teams, ensuring traceability, and supporting training and post-implementation reviews.

Responsibilities include developing requirements strategies, maintaining scope, facilitating communication with stakeholders, and driving business readiness.