Senior Business Analyst – Covered California Billing

CalOptima; Orange (CA); Hybrid; USD 78,000 - 125,000; Full time

Job summary

CalOptima Health in California is seeking a Senior Business Analyst (Covered California) to join our Premium Billing & Member Enrollment team. You will be integral to analyzing enrollment and premium billing functions, translating requirements into actionable system solutions and supporting production operations.

You will collaborate with Operations, IT, Finance, Customer Service and vendors to improve processes, ensure regulatory compliance and deliver data-driven insights that support

Qualifications

• Bachelor's degree in business, healthcare administration, finance, information systems or related field plus 3 years of experience supporting system implementations or operational process improvement in health care operations, enrollment, billing, finance or business analysis.
• Experience in reporting and data analysis required.

Responsibilities

• Analyze enrollment and premium billing processes and translate business requirements into system specifications.
• Develop and support documentation, reports and dashboards to guide operational decision-making.
• Collaborate with Operations, IT, Finance, Customer Service, Compliance, vendors and delegated entities to improve processes and ensure regulatory alignment.
• Coordinate User Acceptance Testing (UAT), validate functionality and support defect resolution.
• Conduct impact analyses for regulatory, operational and system changes; perform gap analysis between current and future processes.
• Develop, organize and maintain SOPs, process documentation and production support materials.
• Support end-to-end premium billing implementation and operational readiness.
• Provide data-driven insights to drive cross-functional initiatives.

Skills

Business analysis

Data analysis

Process improvement

Requirements gathering

UAT coordination

Education

Bachelor's degree in business, healthcare administration, finance, information systems or related field

Tools

Jira/Confluence

ServiceNow

Smartsheet

MS Project

Facets

QNXT

Job description

CalOptima Health in California is seeking a Senior Business Analyst (Covered California) to join our Premium Billing & Member Enrollment team. You will be integral to analyzing enrollment and premium billing functions, translating requirements into actionable system solutions and supporting production operations.

You will collaborate with Operations, IT, Finance, Customer Service and vendors to improve processes, ensure regulatory compliance and deliver data-driven insights that support