Vaiticka SolutionRemote
Business System Analyst
United States of America
Full-time
3 weeks ago
$55 USD
H1B Sponsor
Key skills
Healthcare payer experienceMember portal experienceSQL proficiencyBRDsFRDsAgile/Scrum experienceUXaccessibility knowledgeCommunication skillsSQLData EngineeringAgileScrumCommunication
About this role
Vaiticka Solution is seeking a Senior Healthcare Business Systems Analyst with over 10 years of experience in the healthcare payer domain. This role focuses on analyzing, designing, and implementing digital solutions to enhance member engagement and operational efficiency.
Responsibilities:
- Act as the functional SME for member portals, mobile apps, and digital platforms
- Convert member experience needs into functional specs, user stories, and acceptance criteria
- Lead design for digital features like:
- Eligibility & benefits
- PCP selection
- ID card retrieval
- Claims history
- Prior auth tracking
- Wellness/rewards
- Improve navigation, personalization, and accessibility
- Work with UX/UI teams to align designs with standards and business goals
- Perform gap analysis, process modeling, and requirement mapping
- Create BRDs, FRDs, STTMs, workflows, and traceability matrices
- Use SQL for data validation (eligibility, enrollment, provider data, claims)
- Partner with data engineering teams on data ingestion, transformations, and quality checks
- Collaborate with product, business, IT, operations, compliance, and digital teams
- Lead cross-functional sessions, act as bridge between business and technical teams
- Present complex concepts in simple, business-friendly language
- Manage backlogs and prioritization in Agile/Scrum environments
- Define and lead UAT for portal releases (functional, regression, accessibility, mobile)
- Validate real-time and batch data flows for accuracy and compliance
- Work with QA teams to ensure business rules and data scenarios are covered
- Ensure portal solutions align with HIPAA, CMS, and Medicaid regulations
- Support audits, documentation, and security reviews involving PHI/PII
Requirements:
- 10+ years of healthcare payer experience in BSA/system analysis roles
- Strong understanding of Medicaid, Medicare, ACA, commercial plans
- Hands-on experience with member portal or digital self-service platforms
- Skilled in BRDs, FRDs, user stories, STTMs, process mapping, and gap analysis
- SQL proficiency for data validation/profiling
- Experience with enterprise data platforms, APIs, and middleware
- Strong communication skills; ability to translate between business & technical teams
- Experience in Agile/Scrum
- Familiarity with UX, accessibility, and modern digital design principles