Business Systems Analyst

EPITEC is seeking an experienced Medicare Business Systems Analyst to support a large Medicare Advantage health plan during a critical system transformation and Annual Enrollment Period readiness. The role involves partnering with business, IT, and vendor stakeholders to ensure accurate requirements delivery and continuity of operations during a high-impact period.

Responsibilities:

• Serve as a Business Systems Analyst supporting Medicare Advantage operational processes during system migration and AEP preparation
• Elicit, analyze, and document business and technical requirements related to: Medicare enrollment and eligibility, Premium billing and payment processing, Member fulfillment (ANOC, EOC, Formularies, member letters, etc.)
• Translate business needs into clear functional and technical requirements for development teams
• Collaborate with developers and technical teams to clarify requirements, support solution design, and answer implementation questions
• Create, maintain, and execute test cases and test scenarios to validate system changes
• Support functional testing, integration testing, and user acceptance testing (UAT); document defects and track resolution
• Manage and track work in JIRA, including user stories, acceptance criteria, assumptions, and status reporting
• Develop and maintain current and future state process flows using Visio
• Support system conversion activities including gap analysis, workflow changes, and operational readiness
• Participate in Agile ceremonies such as daily stand-ups, sprint planning, backlog refinement, and retrospectives
• Identify risks, issues, and dependencies tied to migration and AEP timelines and escalate as needed

Requirements:

• 5+ years of experience as a Business Analyst or Business Systems Analyst within a Medicare Advantage (MAPD) plan
• Strong experience writing, executing, and managing test cases and supporting UAT
• Proven ability to work closely with developers to deliver technical and functional requirements
• Hands-on experience with JIRA (user stories, backlogs, sprint tracking, defect management)
• Experience creating process documentation and workflow diagrams using Visio
• Solid understanding of Medicare Advantage operations, including: Enrollment and eligibility, Premium billing and payment processing, Member fulfillment processes
• Experience working in Agile delivery environments
• Strong analytical, documentation, and stakeholder communication skills
• Ability to operate independently and ramp up quickly in a complex, regulated healthcare environment
• Experience with Epic Tapestry (payer platform)
• Prior experience supporting TriZetto Facets, EAM, TCS, or similar core administration platforms
• Experience supporting system migrations or large-scale system conversions
• Familiarity with CMS regulations impacting Medicare Advantage operations
• Prior experience supporting Annual Enrollment Period (AEP) or peak enrollment cycles