Healthcare Business System Analyst

UST HealthProof is a trusted partner for health plans, offering integrated ecosystem solutions for health plan operations. They are seeking a Healthcare Business System Analyst to capture business requirements and implement their core-admin ecosystem, while managing stakeholder communications and developing functional requirements for various healthcare systems.

Responsibilities:

• Leading business requirement conversations with customer and internal teams
• Managing the end-to-end requirements involving all the stakeholders
• Responsible for developing business and functional requirements for Claims, Enrollment, Provider, Authorization, Payment systems
• Create solutions for current business processes using HealthProof’s core-admin ecosystem
• Negotiate with client to develop processes that are current and applicable to the situation

Requirements:

• Bachelor's degree or higher in business or technical field
• 7+ years of relevant work experience in business analysis
• Knowledgeable in Healthcare insurance domain (Medicare, Medicare Advantage, Medicaid, ACA or Commercial)
• Experience with mapping of EDI healthcare transactions (837, 834, 835,270/271, 276/277, 278)
• Experience in analysing the business requirements and translating/mapping them to technical requirements in EDI technology by analysing implementation/companion/TR3 guides
• Experience documenting requirements or user stories and communicating the requirements to technical teams, partners/vendors or product teams
• Experience working in an onshore/offshore model is a must
• Skills & Competencies: Awareness to Agile tools and scrum methodologies
• Communication skills with peers, customers, and partners including the ability to convey information effectively
• Experience working HealthEdge applications like HealthRules Payor or GuidingCare is a plus
• Understanding of SQL, XSDs is a plus