Business Systems Analyst (Healthcare Payer/Member Domain)

E-Solutions, Inc.United States🇺🇸United StatesPosted Oct 1, 2026

Why This Role Stands Out

This remote Business Systems Analyst role offers a fantastic opportunity to leverage your extensive healthcare payer domain expertise to drive impactful projects within a reputable company. You'll thrive in this position if you have a strong background in member enrollment, eligibility, and benefits administration, and are eager to contribute to innovative solutions. Apply today to advance your career in this dynamic field!

Quick Overview

Seniority

Mid Senior

Work mode

Hybrid

Location

United States

Posted

2 weeks ago

SQLScrumAgileConfluenceJiraStakeholder Management

Job Description

Role: Business Systems Analyst (Healthcare Payer/Member Domain)
Experience: 10+ years
Location: Remote (USA)

Must-Have Domain Skills

Healthcare Payer / Member Domain
Member Enrollment & Eligibility
Benefits Administration
Medicare, Medicaid, ACA Exchange Programs
Member Operations

Business Analysis Skills

Requirement Gathering & Analysis
BRD/FRD Documentation
Functional Specifications & User Stories
Process Mapping & Gap Analysis
Data Analysis
UAT Support
Stakeholder Management

Technical Skills

SQL
Data Mapping
API & Interface Analysis
EDI Transactions

Key Responsibilities

Gather and document business/functional requirements
Translate requirements into user stories and system specifications
Support member enrollment, eligibility, and benefits processes
Conduct process mapping, data mapping, and gap analysis
Work with APIs, integrations, and EDI transactions
Perform SQL-based data validation and analysis
Support UAT, defect management, and business sign-offs
Collaborate with business, operations, QA, and technical teams

Good to Have

Agile/Scrum experience
Jira & Confluence
Healthcare payer systems knowledge
Data integration/interoperability concepts
Understanding of system integrations and data flows

Ideal Candidate

✅ Strong Healthcare Payer/Member domain experience
✅ Medicare/Medicaid/ACA expertise
✅ Hands-on SQL and Data Mapping skills
✅ Experienced in Requirements Gathering, UAT, and Stakeholder Management
✅ Familiar with APIs, EDI, and Agile environments

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Business Systems Analyst (Healthcare Payer/Member Domain)1EDI,UAT,✅ Strong Healthcare Payer/Member domain experience ✅ Medicare/Medicaid/ACA expertise ✅ Hands-on SQL and Data Mapping skills ✅ Experienced in Requirements Gathering,and Stakeholder Management ✅ Familiar with APIs,and Agile environmentsN/AC2CUnited States

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Business Systems Analyst (Healthcare Payer/Member Domain)

Why This Role Stands Out

Quick Overview