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Sentara Health in Richmond, VA is seeking a Senior Business System Analyst to support, enhance, and implement software for enrollment and eligibility. You will collaborate with business units, IT, and vendors to elicit requirements and develop tests, guiding projects through SDLC.
The role offers remote work options across many states; 4 years of relevant experience, SQL, HTML, and CSS are required, with Salesforce, QNXT, Edifecs experience a plus.
City/State Richmond, VA Work Shift Multiple shifts available
Sentara is hiring a Senior Business System Analyst! This position is fully remote. Work Location: Remote opportunities available in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington (state), West Virginia, Wisconsin, Wyoming.
Overview This position is responsible for support, enhancement and implementation software applications used within the organization. Oversees and directs intermediate scale projects or components of large-scale projects; develops project plans and timelines and coordination of project resources.
Description Incumbent will identify opportunities to leverage technologies in areas that improve and enhance the business practices by designing and implementing application/product enhancements. Works with and is a liaison to customers and end-users, appropriate IT personnel and software vendors on a regular basis to align technology functionality to operational processes. Assess, research, analyze, and document stakeholder needs, selecting the appropriate information gathering and/or modeling technique to elicit requirements. Develop detailed test cases, execute them, and share results with business and tech managers for approval. Work jointly with developers to solution and provide cost and time estimates on fixes and enhancements. Performs longer term analysis and design of systems and hardware to maintain the production environments. Synthesize requirements and develop recommendations that best meet the objectives of the business. Works on project teams that are developing or modifying very complex information systems.
Serve as the primary liaison between business units, IT groups, and external partners regarding Enrollment and Eligibility processes, with a focus on EDI 834 file exchanges Elicit detailed requirements from stakeholders for the onboarding and maintenance of EDI 834 transactions Analyze, map, and document data flows, business processes, and system interfaces—particularly for enrollment and eligibility functions Review and validate inbound and outbound EDI 834 files to ensure data integrity and compliance with industry and regulatory standards Utilize methodologies such as Agile, Waterfall, and SDLC to manage and support projects related to enrollment and eligibility Develop and execute SQL queries for data analysis and troubleshooting of EDI 834 transactions and enrollment data Identify and mitigate operational and technological risks associated with enrollment file exchanges and eligibility processing Lead testing, troubleshooting, and enhancement activities for enrollment systems and EDI integrations Build and maintain strong relationships with internal teams and external partners (e.g., plan sponsors, TPAs) Proactively identify opportunities for business process improvement and innovation within enrollment and eligibility operations Drive initiatives to increase customer satisfaction by streamlining EDI processes, enhancing data accuracy, and optimizing workflows Evaluate project team performance and ensure objectives, targets, and timelines for enrollment and eligibility enhancements are consistently met Oversee the design and implementation of new enrollment-related solutions and assess their impact on customer satisfaction and operational efficiency Create and distribute monthly performance and operational analysis reports using Tableau, Excel, and other analytic tools Stay informed of regulatory changes and industry trends regarding EDI 834, HIPAA, and member enrollment Provide training and guidance to junior analysts and business units on EDI 834 standards and enrollment practices.
Bachelor’s degree preferably in a field such as Computer Science, Business, Technical, Education, Information Systems, Finance, Business Administration, Accounting, Engineering, Information Technology (Required) or Candidates without a bachelor’s degree with 6 or more years of relevant experience may be considered.
Experience: 4 years of relevant experience (Required) Proficiency in SQL, HTML, and CSS (Preferred) Must have experience working in SQL Understanding of Software Development Life Cycle Nice to have experience working in Salesforce, QNXT, Edifecs.
We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits. The base pay rate for full-time employment is: $69,876 – $116,438. Additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Talroo-health plan, Member enrollment, EDI-834, project management, inbound, member eligibility, QNXT, Facets, SQL, reporting, queries, enrollment, Medicaid, commercial, health plans, HIPAA, Salesforce
We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits. The base pay range for full-time employment is $100,817.60 - $149,656.00 annually. Additional compensation may be available for this role, such as shift differentials, standby/on-call pay, shift premiums, extra-shift incentives, or bonus opportunities. Compensation within the range may vary based on qualifications, experience, location, market conditions, and business needs. Note: If an annual salary is posted, it is based on a full-time colleague working 2,080 hours annually.
Sentara offers a comprehensive benefits package, including medical, dental, vision, life and disability insurance; 401(k)/403(b) with employer match; paid time off (vacation, sick time, and holidays); paid parental and military leave; educational assistance or student loan repayment; and voluntary benefits.
Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
In support of our mission “to improve health every day,” this is a tobacco‑free environment.
For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, NewHampshire, NorthCarolina, NorthDakota, Ohio, Oklahoma, Pennsylvania, SouthCarolina, SouthDakota, Tennessee, Texas, Utah, Virginia, Washington, WestVirginia, Wisconsin, and Wyoming.
Sentara Health is a Virginia and Northeastern North Carolina based not‑for‑profit integrated healthcare provider that has been in business for over 131 years. Offering hundreds of sites of care including 12 hospitals, PACE, home health, hospice, medical groups, imaging services, therapy, outpatient surgery centers, and an858,000 member health plan.
The people of the communities that we serve have nominated Sentara “Employer of Choice” for over ten years. U.S. News and World Report has recognized Sentara as having the Best Hospitals for15+years.
Sentara offers professional development and a continued employment philosophy!