Why this role stands out
This hybrid role offers a fantastic opportunity to leverage your extensive healthcare payer and COB expertise within a dynamic consulting environment, driving impactful solutions for clients. You'll thrive here if you possess deep domain knowledge and strong analytical skills, contributing to innovative projects while enjoying flexibility. Apply now to advance your career in a rewarding setting!
Quick overview
Job description
- 18+ years of overall Business Analysis experience with 10+ years focused on Healthcare Payer operations and at least 7+ years in Coordination of Benefits (COB), Eligibility, Enrollment, and Member Data Management domains.
- Deep domain expertise in:
- Coordination of Benefits (COB)
- Primacy Determination
- Enrollment & Eligibility
- Medicare Secondary Payer (MSP)
- Medicaid Coordination Rules
- NAIC COB Guidelines
- Healthcare Payer Operations
- Member Matching / EMPI
- Provider and Payer Ecosystems
- Strong SQL and data analysis capabilities.
- Experience analyzing complex healthcare datasets.
- Familiarity with Azure-based data platforms and modern cloud ecosystems.
- Understanding of API-driven architecture and microservices.
- Hands-on experience with HL7 and FHIR standards.
Business Analysis Skills
- Expert in requirements elicitation and stakeholder management.
- Strong process modeling skills (BPMN, Visio, Lucidchart, etc.).
- Experience working within Agile/Scrum and SAFe delivery models.
- Strong documentation and communication capabilities.
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