Sr. Healthcare Business Analyst

job summary:

We are looking for a Sr. Business Analyst with extensive experience in healthcare insurance ideally with medical appeals or large plan implementations projects. This is a remote role that can be based on 1 of 28 approved states. Elicit, analyze, document and manage requirements for changes to business processes, policies, information, and information systems for larger and/or more complex business problems.

Develop and elicit requirements for departmental and corporate projects that are more complex in nature as requested by internal/external customers; prepare business and functional requirements.

Communicate and validate requirements with stakeholders and identified SMEs.

Ensure creation of and adherence to requirements approach and management plan in alignment with an overall project plan. Collaborate with project teams to adhere to solution scope and create and maintain requirements traceability.

Drive and execute business readiness activities including the communication plan to support changes to technology, processes and people.

Support training and conduct focused analysis to ensure efficiency of project implementations and ensure desired results.

Develop new procedures, specifications for systems changes or other solution recommendations for more complex product and/or process changes. Work with cross functional management and staff to implement changes.

Design and conduct post implementation audits and create customer feedback mechanisms to gather ongoing information about business processes. Analyze results and create plans to address weaknesses.

Identify the business process and organizational impact of solutions; conduct analysis of workflow process and designs, test and implement solutions. Ensure managed requirements change request process and documentation throughout project lifecycle

Develop and maintain reporting tools for use in measuring business area performance against metrics/industry benchmarks and ensuring data integrity and systems stability in support of operations management.

Provide timely and accurate access to data, distribute reports and present/explain results to business area supported as well as to other areas.

location: Telecommute
job type: Contract
salary: $40 - 45 per hour
work hours: 9am to 5pm
education: Bachelors
responsibilities:

• Elicit, analyze, document and manage requirements for changes to business processes, policies, information, and information systems for larger and/or more complex business problems.
• Develop and elicit requirements for departmental and corporate projects that are more complex in nature as requested by internal/external customers; prepare business and functional requirements.
• Communicate and validate requirements with stakeholders and identified SMEs.
• Ensure creation of and adherence to requirements approach and management plan in alignment with an overall project plan. Collaborate with project teams to adhere to solution scope and create and maintain requirements traceability.
• Drive and execute business readiness activities including the communication plan to support changes to technology, processes and people.
• Support training and conduct focused analysis to ensure efficiency of project implementations and ensure desired results.
• Develop new procedures, specifications for systems changes or other solution recommendations for more complex product and/or process changes. Work with cross functional management and staff to implement changes.
• Design and conduct post implementation audits and create customer feedback mechanisms to gather ongoing information about business processes. Analyze results and create plans to address weaknesses.
• Identify the business process and organizational impact of solutions; conduct analysis of workflow process and designs, test and implement solutions. Ensure managed requirements change request process and documentation throughout project lifecycle
• Develop and maintain reporting tools for use in measuring business area performance against metrics/industry benchmarks and ensuring data integrity and systems stability in support of operations management.
• Provide timely and accurate access to data, distribute reports and present/explain results to business area supported as well as to other BCBSNC areas. Work with trainers to develop training programs that target problem areas.
• Use and promote industry standard analysis techniques, such a data flow modeling, use-case analysis, workflow analysis, business process mapping, functional decomposition analysis and/or financial ROI modeling for larger and more complex initiatives.
• Independently create effective presentations for review by varied levels of leadership; thoroughly document all analysis assumptions, procedures and results in a manner appropriate for both senior executive and management review.
• Proactively identify areas of potential business risk, on projects both within and outside of control, make recommendations related to mitigation and escalate as necessary
• Build and support strong business vendor relationships by documenting business issues, determining project needs, and supporting training as needed.
• Provide oversight and regularly perform peer reviews for less experienced analysts.

Hiring Requirements

- Bachelor's degree or advanced degree (where required)

- 5+ years of experience in related field.

- In lieu of degree, 7+ years of experience in related field.

qualifications:

7+ years as a BA with healthcare insurance exp

Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.
At Randstad Digital, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact
Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad Digital offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).
This posting is open for thirty (30) days.
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.