Business Analyst (Remote)

CareFirst BlueCross BlueShield is seeking a Business Analyst to ensure that the business's needs for changes to processes and information systems are identified and documented. The role involves collaborating with various teams to define requirements, support user acceptance testing, and analyze enrollment processes for improvements.

Responsibilities:

• Elicit, analyze, and document business requirements related to enrollment operations, including Medicare Advantage and Medicaid processes
• Collaborate with enrollment, compliance, and IT teams to define requirements for system enhancements, regulatory updates, and operational workflows
• Translate enrollment business needs (e.g., 834 file processing, eligibility verification, dual enrollment workflows) into functional specifications
• Participate in requirements validation sessions to ensure alignment with CMS and state requirements
• Track and manage issues related to enrollment processes and system functionality, supporting resolution efforts
• Support and participate in user acceptance testing (UAT) for enrollment-related system changes, including Enrollment Administration Manager (EAM) and FACETS systems
• Develop and execute test scenarios aligned to enrollment workflows and regulatory requirements
• Identify and document gaps, defects, and discrepancies impacting enrollment processing accuracy
• Coordinate issue resolution with stakeholders and support validation of fixes
• Provide guidance and support to end users on system updates and enrollment-related functionality
• Analyze and troubleshoot issues related to enrollment processing, reconciliation, and data discrepancies
• Collaborate with operations, compliance, and IT to resolve enrollment-related system and process issues
• Support investigation of complex enrollment scenarios, including retro enrollments, disenrollments, and eligibility discrepancies
• Assist in identifying root causes and recommending solutions to improve enrollment accuracy and efficiency
• Document and maintain detailed enrollment workflows, SOPs, and business requirements
• Analyze current enrollment processes to identify gaps, inefficiencies, and opportunities for improvement
• Support development of job aids and training materials related to enrollment systems and processes
• Ensure documentation reflects current CMS and state regulatory requirements
• Support enrollment-related projects by coordinating requirements, timelines, and deliverables
• Monitor and report on project status, risks, and dependencies
• Assist in prioritizing work requests related to enrollment systems, regulatory changes, and operational improvements
• Contribute to reporting and analysis of enrollment metrics (e.g., error rates, reconciliation discrepancies, processing timelines)

Requirements:

• Bachelor's Degree in Business, Health Care, Information Technology, Computer Science or related field OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience
• 5 years of experience in functional, operational, business, data, systems or testing analysis
• 3 to 5 years of Medicare Advantage and/or Medicaid experience, preferably in enrollment
• Strong time-management and organizational skill
• Excellent communication skills both written and verbal
• Ability to organize stakeholder meetings
• Microsoft Office applications usage
• Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence
• Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging
• Demonstrated ability to deliver high quality, effective deliverables on-time and be a valuable contributor to the development of cost-effective solutions
• Moderate understanding of business analysis core competencies