Business Analyst - Provider

JOB TITLE: Business Analyst - Provider
JOB LOCATION: Remote
WAGE RANGE*: $110k to $120k
JOB NUMBER: 26-01293

REQUIRED EXPERIENCE:

Five or more years of Business Analysis experience, or equivalent experience supporting complex technology initiatives.
Supports Provider Data Maintenance, provider enrollment, re-enrollment, revalidation, recredentialing, provider disclosure, taxonomy, portal, and related interface initiatives.
Provider enrollment and maintenance workflows

JOB DESCRIPTION

The Business Analyst (BA) serves as the liaison among client and business stakeholders, leadership, functional subject matter experts, project management, testing teams, and technical teams.
The BA is responsible for eliciting, analyzing, documenting, validating, and managing business and system requirements for assigned initiatives and operational changes.
Supports Provider Data Maintenance, provider enrollment, re-enrollment, revalidation, recredentialing, provider disclosure, taxonomy, portal, and related interface initiatives.
Provider enrollment and maintenance workflows
Revalidation, recredentialing, screening, affiliations, and ownership information
Provider taxonomy and program relationships
Provider portal, letters, forms, and external data exchanges
Document provider business rules and workflow changes
Map provider-data and interface impacts
Define portal, notice, form, and batch requirements
Coordinate Provider Operations, technical, interface, and testing validation
Requirements and Analysis

• Facilitate discovery and requirements sessions with client, business, operational, and technical stakeholders.
• Document business, functional, system, interface, reporting, operational, and acceptance requirements.
• Develop process flows, use cases, business rules, decision points, acceptance criteria, and traceability artifacts.
• Identify scope boundaries, assumptions, dependencies, risks, policy questions, and cross-domain impacts.
• Ensure requirements are complete, understandable, testable, reviewed, and approved.

Solution and Delivery Support

• Partner with TFALs, architects, developers, testers, project managers, and subject matter experts to evaluate solution options.
• Support Change Request and Change Order analysis, clarification, estimation, sequencing, and readiness activities.
• Maintain alignment between the approved business need, requirements, solution, testing, and implementation.
• Escalate unresolved requirements, decisions, risks, and dependencies through the appropriate delivery channels.

Testing and Implementation

• Engage testing resources early and support test planning and User Acceptance Testing preparation.
• Review scenarios, test cases, expected results, defects, and outcomes for alignment with approved requirements.
• Support business validation, implementation readiness, stakeholder communications, and post-implementation review.

Stakeholder Management

• Serve as a clear communication bridge between client and business stakeholders and delivery teams.
• Facilitate productive workshops, reviews, and decision-making discussions.
• Document decisions and communicate impacts, risks, assumptions, dependencies, and required actions.
• Build effective working relationships across functional domains and shared-service teams.

Qualifications and Capabilities

• Five or more years of Business Analysis experience, or equivalent experience supporting complex technology initiatives.
• Strong requirements elicitation, analysis, documentation, facilitation, and validation skills.
• Working knowledge of system development lifecycle and change-delivery practices.
• Ability to work independently in a complex, client-facing environment.
• Strong analytical, problem-solving, written communication, verbal communication, and stakeholder-management skills.
• Understanding of testing methodologies, requirements traceability, and business validation.
• Medicaid, healthcare, or government-program experience preferred.

Equal opportunity employer as to all protected groups, including protected veterans and individuals with disabilities

* While an hourly range is posted for this position, an eventual hourly rate is determined by a comprehensive salary analysis which considers multiple factors including but not limited to: job-related knowledge, skills and qualifications, education and experience as compared to others in the organization doing substantially similar work, if applicable, and market and business considerations. Benefits offered include medical, dental and vision benefits; dependent care flexible spending account; 401(k) plan; voluntary life/short term disability/whole life/term life/accident and critical illness coverage; employee assistance program; sick leave in accordance with regulation. Benefits may be subject to generally applicable eligibility, waiting period, contribution, and other requirements and conditions. Benefits offered are in accordance with applicable federal, state, and local laws and subject to change at TCM's discretion.

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