Business Analyst
Core
Capture business requirements for Health plan customer's Core admin business functions and implement UST HealthProof's core-admin ecosystem.
Role type
Senior Business Analyst (Healthcare Payor)
Builds
Core admin solutions for health plans
Domain
Healthcare insurance (Payor)
Required skills
Requirement elicitation, Claims adjudication, Enrollment, Provider management, Payment processing, EDI transaction mapping (837, 834, 835, 270/271, 276/277, 278), Agile/Scrum, Workflow diagramming, User story creation, Offshore collaboration
Preferred skills
HealthEdge applications (HealthRules Payor, GuidingCare), SQL, XSDs
Technologies
UST HealthProof core-admin ecosystem, Agile tools, EDI technology
Responsibilities
Lead business requirement conversations with customers and internal teams, Develop business and functional requirements for Claims, Enrollment, Provider, Authorization, Payment systems, Create solutions for current business processes, Negotiate client processes, Collaborate with business users, management, IT, and offshore staff, Translate healthcare business requirements to functional and technical requirements, Develop high level workflow diagrams and system context diagrams, Document process flows using swim lanes diagrams, Produce Requirements plan, Dictate risks and dependencies, Work with Offshore Business Analysts to elaborate user stories, Conduct Requirement walk through, Collaborate with development team & QA team, Contribute to sprint planning and go-live evaluation, Conduct Demo of MVPs
Seniority
Senior, hands-on IC