Req ID: 302720

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We are currently seeking a Healthcare Payer Busines Analyst - Remote to join our team in Denver, Colorado (US-CO), United States (US).

Provides cost effective business systems and applications analysis in support of the development and implementation of business applications. Includes evaluation, analysis, documentation of requirements, translation into proper system requirement specifications and configuration. Formulates and defines systems scope and objectives based on both end-user needs and a thorough understanding of business systems, applications and industry requirements. Conducts business process analyses, needs assessments, and preliminary cost/benefits analyses in an effort to align information technology solutions with business initiatives. Operates as a liaison between technical personnel and the end-users. Teaches end users new technology and enhancements using all appropriate communication tools.

• Customer interaction, attend meetings with customer and onshore team.
• Understand the application/product functionality and clarify the queries raised by the internal or external team.
• Support with analysis and recommendations.
• Analyze the problem raised by the customer or understand the requirement.
• Creating user requirements specifications document for internal/regulatory projects not sponsored by external customers.
• Validate the data after the application process/ jobs complete.
• Proactively analyze the risk and alert the team, also come up with mitigation plan & solution.
• Interact with customers and propose solutions.
• Providing high-level estimates of the necessary work effort to document requirements.
• Refining high-level estimates as more detailed requirements are captured and analyzed.
• Working to specific effort estimates and providing immediate feedback to the Project Manager if the estimates will be exceeded.
• Plan and conduct interviews with business areas (end-users and managers) and technical staff.
• Coordinate with team members for peer and client reviews of documentation.
• Support the project delivery team during design, construction, and testing of the project and facilitate.
• Provide detail design documentation including business rules, changes to UI and processing logic for enhancement to Health insurance enrollment, payments and billing.
• Support project teams on an as-needed basis (including but not limited to, review test cases/test plan of the assigned project, research defects, and provide design for correction).
• Provide the training to juniors on functionality and monitor the work done by junior team members.

• Minimum 10 years of experience supporting and/or designing Health Plan Core Administration system and ancillary systems.
• Minimum 5 years of experience supporting Medicaid line of business.
• Minimum 3 years of experience supporting Medicare line of business.
• Minimum 3 years of experience supporting Commercial line of business.
• Minimum 10 years of experience with elicitation and verification of business and technical requirements.
• Minimum 5 year of experience with system development methodology.
• Minimum 5 year of experience conducting reviews of system development life cycle documentation, project and technical architecture and design deliverables/artifacts.
• Minimum 5 years of EDI X12 transactions experience including 837, 835, 834, 276/277, 997/999.
• Ability to create simple PL/SQL as required.
• Ability to translate between non-technical business users and technical IT resources.
• Good knowledge of Word, Excel, and PowerPoint.
• Strong verbal and written communication skills.
• Excellent follow-through skills with strong attention to detail.
• Ability to work independently or as part of a team.
• Adaptive and open to frequent changes in work environment and prioritization.
• Able to manage multiple competing deadlines.

• Experience translating Federal and State regulations into working requirements that are actionable by technical teams
• Xcelys Core Administration Processing System