Sr. Business Analyst - Health Plan

Remote with Possible Future Travel Full-time

• Projé has an exciting opportunity for a full-time Senior Business Analyst. The Senior Business Analyst will be responsible for the assessment, analysis, testing and requirements gathering and documentation related to Health Plan processes. The ideal candidate will possess detailed knowledge of the Health Plan's operations including but not limited to claims, billing, membership/enrollment, provider, customer service and clinical operations (UM, CM, DM, Risk).

Responsibilities

• Conducts the analysis and documentation of current state and future state, documenting gaps in the design of the future state workflows, to optimize system/operational functionality.
• Facilitates and elicits requirements for projects, while effectively managing changes and conflicts during the project lifecycle.
• Responsible for working with stakeholders to gain an in-depth understanding of critical business requirements; analyzing data models to deliver logical conclusions; developing innovative solutions for operational and strategic changes; being proficient in inventing processes; and conducting tests, surveys, and workshops to ensure positive outcomes.
• Develops use cases, test scenarios and test cases. Communicate and apply testing methodologies to ensure quality is delivered.
• Manages Business Process Modeling and Workflows.
• Develops and documents Desk Level Procedures (DLPs) and Standard Operational Procedures (SOPs) as needed.
• Participates in meetings and presentations effectively and professionally.  Provides documentation for meetings to report progress, issues and possible resolutions.
• Applies system analysis techniques and procedures, including consulting with users to determine hardware, software or system functional specifications.
• Establishes and maintains collaborative relationships with all associated departments, workgroups, and vendors as required. Communicates effectively and concisely to promote positive relationships.

Key Qualifications

• Solid understanding of health plan (payer) operations, including but not limited to, claims, membership/enrollment, billing, provider, customer service and clinical operations (UM, CM, DM, Risk).
• Strong analytical, problem solving, negotiation and collaboration skills.
• Proven ability to participate in several projects at the same time.
• Expert skills with MS Office Suite, Visio, MS Project, and SharePoint required.
• Experienced in Commercial, Medicare, Medicaid and Self-Funded (ASO) lines of business.
• Knowledge of Health plan software systems.

Perks

• Competitive pay and bonuses
• Excellent benefits (medical, dental, vision)
• 401K with percentage company match
• Paid holidays and vacation days
• Flexible schedule

Education and Experience

• At least 5 years of experience working with or for a health insurance company.
• Associates or Bachelor’s Degree in Information Management or comparable work-related experience.

We get projects done, and help people along the way.

​We work with payors and providers to manage, implement, test, and deploy systems that provide increased efficiency, process improvements, and high quality outcomes.

We are committed to achieving project deliverables and take pride in our clients’ success.

Since our founding in 2004, Projé has built a stellar reputation of excellence through the dedication and commitment of our expert consultants who live out Projé’s mission every day.

Job Type: Full-time

Pay: $75,000.00 - $145,000.00 per year

Benefits:

• 401(k) matching
• Dental insurance
• Flexible schedule
• Health insurance
• Paid holidays
• Paid time off
• Parental leave
• Vision insurance

Compensation Package:

• Bonus opportunities

Schedule:

• 8 hour shift

Application Question(s):

• What is your requested salary and do you require benefits?
• Do you require Visa sponsorship?
• Are you willing to travel occasionally if/when requested by Client?

Experience:

• Health Plan Payer Industry: 5 years (Required)

Language:

• English (Required)

Work Location: Remote