Sr Business Analyst, Provider Claims (Remote)

Lensa; City of Yonkers (NY); Remote; USD 77,000 - 129,000; Full time

Job summary

A leading company in IT services is seeking a Sr Business Analyst to analyze complex business problems and provide insights using data. The role involves collaborating with clients, creating documentation, and participating in project stages. Candidates should have a Bachelor's Degree and significant experience in business analysis and managed care.

Qualifications

• 5-7 years of business analysis experience required.
• 6+ years of managed care experience preferred.
• CBAP or similar certification is a plus.

Responsibilities

• Analyze complex business problems using data from various sources.
• Create Business Requirements Documents and Test Plans.
• Participate in all project stages to ensure functional requirements are met.

Skills

Requirements Elicitation

Process Improvement

Communication

Organizational Skills

Time Management

Education

Bachelor's Degree

Tools

Salesforce

Facets

Excel

Job description

Sr Business Analyst, Provider Claims (Remote)

15 hours ago Be among the first 25 applicants

Lensa is the leading career site for job seekers at every stage of their career. Our client, Molina Healthcare, is seeking professionals. Apply via Lensa today!

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 a course of action. This role involves working with various types of business data, either internal operations-focused or external client-focused.

Knowledge/Skills/Abilities

• Elicit requirements through interviews, document analysis, and workshops, including business process descriptions, use cases, and workflow analysis.
• Interpret customer business needs and translate them into application and operational requirements.
• Communicate and collaborate with internal and external customers to analyze needs, goals, and transform them into functional requirements, delivering appropriate artifacts.
• Work with operational leaders to recommend process improvements, cost savings, or revenue enhancements.
• Create Business Requirements Documents, Test Plans, Requirements Traceability Matrix, User Training materials, and other documentation.
• Participate in all project stages—research, design, programming, testing, and implementation—to ensure the product meets functional and operational requirements.

Job Qualifications

Required Education: Bachelor's Degree or equivalent experience
Required Experience:

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

Preferred Experience:

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

Preferred Certifications: CBAP or similar from IIBA

To apply, current Molina employees should use the intranet. Molina Healthcare offers competitive benefits. We are an Equal Opportunity Employer.

Pay Range: $77,969 - $128,519 annually. Actual compensation varies based on location, experience, education, and skills.

Additional Details

• Seniority level: Mid-Senior level
• Employment type: Full-time
• Job functions: Research, Analysis, IT
• Industries: IT Services, Consulting