Job Description

Job Description

Job Description

About the Role

We are seeking a passionate, results-oriented Senior Enterprise Business Analyst who can collaborate effectively with internal and external stakeholders to analyze, define and manage requirements to launch new product & services. The ideal candidate will have worked in-depth for top payers across one or more domains (Enrollment & Benefit Administration, Claims processing & Reimbursements, Member & Provider Portals/Service, Clinical & Care management, Funding & Billing, Reporting). This person must possess a blend of business and technical savvy; strong communication skills to collaborate across internal and external stakeholders.

This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities and activities may change, or new ones may be assigned at any time with or without notice.

Primary Responsibilities

• You will work with business and solution owners to define and document requirements for the assigned products and services, as well as write user stories, acceptance criteria, feature description decks, process flows, manage traceability and UAT.
• You will maintain a solid knowledge base of the functional capabilities of the various areas and products within the assigned product portfolio.
• You will use agile methods to analyze, define and document requirements and manage traceability. You will work with stakeholders and product teams to drive consensus on scope, design and implementation decisions.
• Provide analysis and impact to user and business for changes to current functionalities and applies problem solving skills to meet business needs.
• Develop and integrate requirement management to the delivery approach and schedule; you will also be responsible for product quality, project timeliness, and customer satisfaction.
• Participate in the presentation of information to customer and internal business and or IT teams.
• Creates business / product / third party vendor specifications for product integration and implementation.

Essential Qualifications 

• Minimum 6-7 years of experience as a business analyst in healthcare payer industry.
• Expertise and experience in preparing High Level requirements, UseCases, Business Requirement Documents, Functional specifications, Test strategy & cases and Traceability matrix.
• Proven ability to map business process and workflows, conducting gap analysis and documenting requirements, ensuring requirements are developed and tested.
• Excellent verbal/written communication skills; comfortable leading business and technology teams within the organization to translate business issues & requirements into technical solutions.
• Healthcare Insurance Payer in one of more of the following areas: Claims Administration, Enrollment & Eligibility, Benefit Administration, Contribution Accounting, Billing & Payment, Member, Provider and Employer facing portal/service.
• Ability to analyze problems and resolve issues through resolution quickly and methodically.
• Proficient with Word, Excel, and PowerPoint, Visio.
• Knowledge of BA/ MS project Tools, JIRA, MS Project
• Self-motivated and detail oriented.
• Flexibility to adapt to change and willing to learn and develop new skill sets as applicable.
• Bachelor's degree or equivalent experience. 
• BA Certifications and or PMP a plus.

About

At Brighton Health Plan Solutions, LLC, our people are committed to the improvement of how healthcare is accessed and delivered. When you join our team, you’ll become part of a diverse and welcoming culture focused on encouragement, respect and increasing diversity, inclusion and a sense of belonging at every level. Here, you’ll be encouraged to bring your authentic self to work with all of your unique abilities.

Brighton Health Plan Solutions partners with self-insured employers, Taft-Hartley Trusts, health systems, providers as well as other TPAs, and enables them to solve the problems facing today’s healthcare with our flexible and cutting-edge third-party administration services. Our unique perspective stems from decades of health plan management expertise, our proprietary provider networks, and innovative technology platform. As a healthcare enablement company, we unlock opportunities that provide clients with the customizable tools they need to enhance the member experience, improve health outcomes and achieve their healthcare goals and objectives. Together with our trusted partners, we are transforming the health plan experience with the promise of turning today’s challenges into tomorrow’s solutions.

Come be a part of the  Brightest Ideas in Healthcare™ .

Company Mission

Transform the health plan experience – how health care is accessed and delivered – by bringing outstanding products and services to our partners.

Company Vision

Redefine health care quality and value by aligning the incentives of our partners in powerful and unique ways.

DEI Purpose Statement

At BHPS, we encourage all team members to bring your authentic selves to work with all of your unique abilities. We respect how you experience the world and welcome you to bring the fullness of your lived experience into the workplace. We are building, nurturing and embracing a culture focused on increasing diversity, inclusion and a sense of belonging at every level.

*We are an Equal Opportunity Employer

Annual Salary Range: $95,000 - $150,000

The salary range and/or hourly rate listed is a good faith determination that may be offered to a successful applicant for this position at the time of the posting of an advertisement and may be modified in the future. When determining a team member's base salary and/or rate, several factors may be considered as applicable by law including but not limited to location, years of relevant experience, education, credentials, skills, budget and internal equity.

JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Brighton Health Plan Solutions in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All of our career opportunities are regularly published and updated brighonthps.com Careers section. If you have already provided your personal information, please report it to your local authorities. Any fraudulent activity should be reported to:  [email protected]

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Job Tags

Hourly pay, Local area, Flexible hours,

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