|. Healthcare EDI BRD development & implementation experience - 834, 820 (Enrollment & Billing) as a BA
2. Strong communication & presentation skills
3. Health Insurance Marketplace and/or Duals implementation (nice to have but not mandatory)
Client is seeking Business analyst with specific knowledge in the healthcare enrollment process arena. This requires specific knowledge regarding eligibility/benefit and claims processing model. These are not traditional BA roles with an IT emphasis but more focused on business process model within the claims area of a healthcare plan environment. Experience could include working with call center, configuration changes, provider side, and enrollment. This team is involved in many projects including healthcare reform, long term care, disease management, care management, duals etc, specifically the claims portion of the life cycle within each of these areas. Contract to hire ideally so green card holder or citizenship required
• Responsibilities include gathering and documenting business and system requirements for company initiatives, must have excellent documentation skills, in formal documents as well as good communication via email and in person.
• Maintains and consistently demonstrates a general knowledge of company guidelines, processes, practices and procedures.
• Coordinates project activities involving demos, test team meetings, feedback sessions, focus groups, and orientations.
• Analyzes the relationship between business functions and the system by preparing analysis documents (examples may include requirements, entity relationship models, dataflow diagrams, process specifications and design).
• Ensures a quality end product by conducting thorough system testing.
• Performs cost benefit analysis and assists in developing business cases for projects.
• Determines scope and participates in establishing priorities for system changes.
• Prepares and distributes status reports and other updates to management.
• Assists in preparing for meetings
• Participates in meeting discussions.
• Participates actively in all aspect of project management and control.
• Performs other work as required or requested as well as additional assignments
Other Attributes Desired Agile Methodology preferred.
Technical writing and expertise in documentation and gathering information on existing systems across multiple teams
Expertise in MS Office suite: PowerPoint, Word, Excel and Visio