Job Description

Skill-BUSINESS ANALYST SR type- Regular Notice- 30 days This job supports one or more analytical aspects of the application product life cycle, including capability enablement with cross-team dependencies within a product scope. Uses significant judgement and discretion to collaborate with customers on complex issues in order to understand capability needs, gather project specifications, create business cases and cost sheet analysis, translate high-level business needs into detailed requirements for new capabilities (and change request/enhancements on existing capabilities), analyze data to determine business problems, trends, or opportunities for process improvements, create/execute test cases, provide root cause analysis and corrective action plan, verify delivery of customer needs, and ensure quality delivery. Also responsible for identification, documentation, and resolution of risks, defects and issues. Analyzes market trends for competitive insight to correlate into business value statements. Uses functional and organizational knowledge to mentor Associate and Intermediate Business Systems Analysts. Leads project teams or actively participate as subject matter expert (SME) on moderately complex projects (which are cross functional, with potential regulatory risk exposure, customer service & financial impacts ). Acts as face to the customer. Resolves very complex issues (may involve multiple systems) while understanding potential regulatory risk exposure and customer service & financial impacts. Acts as a SME on how moderately complex new enhancements/applications are developed using advanced level of understanding of end-to-end process and clear understanding of potential integration issues. Requires advanced level of understanding the end systems impact of changes across multiple/diverse systems (including regulatory risk exposure, customer service & financial impacts). Candidate must have worked in US healthcare with experience minimum of 4 years, especially in claims application as business analyst or consultant. Membership and provider domain knowledge/experience is preferable, but must have claims knowledge FEP, ITS (Interplan Teleprocessing system)/Blue card claims and B2 application knowledge/experience is preferable. Work experience in EHR/EMR is also considered, but must have worked or possess knowledge of claims submission to Payers. Should have knowledge in working with all types of claim - medical, hospital, Pharmacy, Dental, Vision, Blue card/ITS etc. Should have the fundamentals of requirement gathering, elicitation, documenting, and transition over to internal and external stakeholders. Should have experience in writing functional specification documents/BRD. Should have ability to solve the complex business problems and exposed to complete software development life cycle (SDLC)Should have sound knowledge in claims testing end to end, work under minimal supervision and take complete ownership of delivery Sound have knowledge of current US federal and state laws with regards to healthcare governance and policies, and preferable to have PAHM/FAHM certifications or working towards certification Business Analysis knowledge is mandatory, and preferable to have certifications like CBA/CBAP or working towards certification. Nice to have work exposure with agile and scrum teams. Preferable to have basic SQL knowledge. Soft spoken, thrive to learn and willing to work in flexible timing, and may require to work on weekend as per business need ESSENTIAL RESPONSIBILITIES . Take a lead role with customers, Software Engineers, Architects, Capability Managers, and other team members to capture capability needs and drive quality business solutions on complex issues. Create and maintain deliverables such as business vision, requirements, testing plan, testing schedule, testing scenarios, testing outcomes, user task analysis, wire framing, usability testing, personalization to different clients, and u

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