Senior Health Payor Business Systems Analyst - Remote

HealthEdge; United States; Remote; USD 120.000 - 140.000; Vollzeit

Zusammenfassung

HealthEdge is seeking a seasoned Business System Analyst to capture and translate health-plan requirements into functional specs. You will work with HealthProof/HealthEdge ecosystems, customer SMEs, and vendor partners to define the core-admin processes from Claims to Payments.

The role emphasizes elicitation, EDI mapping, and agile collaboration across onshore/offshore teams to deliver scalable health admin solutions in a remote US setting.

Qualifikationen

• Bachelor’s degree or higher in business or technical field
• 10+ years of relevant work experience in business analysis
• Experience documenting requirements or user stories
• Experience mapping of EDI healthcare transactions (837, 834, 835,270/271, 276/277, 278)
• Ability to work onshore/offshore model and collaborate with vendors

Aufgaben

• Lead business requirement conversations with customer and internal teams
• Manage end-to-end requirements involving all stakeholders
• Develop business and functional requirements for Claims, Enrollment, Provider, Authorization, Payment systems
• Create solutions for current business processes using health core-admin ecosystem
• Collaborate with development and QA teams to ensure objectives are met
• Contribute to sprint planning, retrospectives, go-live evaluation meetings
• Conduct MVP demos for the customer

Kenntnisse

Healthcare payor domain

EDI mapping

Requirement elicitation

Agile methodologies

Ausbildung

Bachelor’s degree or higher

Tools

HealthEdge applications

HealthRules Payor

GuidingCare

EDI tooling

Jobbeschreibung

HealthEdge is seeking a seasoned Business System Analyst to capture and translate health-plan requirements into functional specs. You will work with HealthProof/HealthEdge ecosystems, customer SMEs, and vendor partners to define the core-admin processes from Claims to Payments.

The role emphasizes elicitation, EDI mapping, and agile collaboration across onshore/offshore teams to deliver scalable health admin solutions in a remote US setting.