Sr Business Analyst, Provider Claims (Remote)

Lensa; Caldwell (ID); Remote; USD 80,000 - 110,000; Full time

Job summary

A leading company is seeking a Senior Business Analyst to analyze complex business problems and provide insights to decision-makers. The role involves collaborating with clients, creating specifications for reports, and recommending process improvements. Candidates should have a Bachelor's degree and 5-7 years of experience in business analysis, particularly in managed care.

Qualifications

• 5-7 years of business analysis experience required.
• 6+ years managed care experience preferred.
• Certified Business Analysis Professional (CBAP) or similar preferred.

Responsibilities

• Analyze complex business problems using data to provide insights.
• Collaborate with clients to tailor reports to their needs.
• Create Business Requirements Documents and Test Plans.

Skills

Elicit requirements

Interpret customer business needs

Proactive communication

Detail-oriented

Organizational skills

Education

Bachelor's Degree

Tools

Salesforce

Facets

Excel reporting

Job description

Sr Business Analyst, Provider Claims (Remote)

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Job Description

Job Summary

Analyzes complex business problems and issues using data from internal and external sources to provide insights to decision-makers. Identifies and interprets trends and patterns in datasets to locate influences. Constructs forecasts, recommendations, and strategic/tactical plans based on business data and market knowledge. Creates specifications for reports and analysis based on business needs and available data elements. Collaborates with clients to modify or tailor existing analysis or reports to meet their specific needs. May participate in management reviews, including presenting and interpreting analysis results, summarizing conclusions, and recommending courses of action. This role involves working with various types of business data and may focus on internal operations or external clients.

Knowledge/Skills/Abilities

• Elicit requirements through interviews, document analysis, and workshops.
• Interpret customer business needs and translate them into application and operational requirements.
• Communicate and collaborate with internal and external customers to analyze needs and deliver appropriate artifacts.
• Work with operational leaders to recommend process improvements, cost savings, or revenue enhancements.
• Create Business Requirements Documents, Test Plans, Traceability Matrices, User Training materials, etc.
• Participate in all project stages to ensure the product meets requirements.

Job Qualifications

Required Education: Bachelor's Degree or equivalent

Required Experience:

• 5-7 years of business analysis experience
• 6+ years managed care experience
• Proficiency in relevant concepts, practices, and procedures
• Ability to manage escalations independently
• Proactive communication skills
• Detail-oriented, adaptable, with strong organizational skills

Preferred Experience

• 3-5 years formal project management training
• Experience with complex technical teams
• Claims investigation within managed care
• Experience working with providers and internal teams
• Familiarity with Salesforce, Facets, Excel reporting
• Claims research experience
• Strong analytical and documentation skills

Preferred Certifications

Certified Business Analysis Professional (CBAP) or similar preferred.

Interested candidates should apply through the intranet if currently employed by Molina. Molina Healthcare offers competitive benefits and is an Equal Opportunity Employer.