Health Care Business Analyst

Job Title: Sr. Healthcare Business Analyst – Team Lead

Location: NY/NJ – Day 1 Onsite

Job Type: Long term contract

Experience: 12+ Years

Mandatory Skills (New update): Healthcare Payer, Billing, Claims, Accounting, TPA – Third-party Application

Job Description:
• Seeking a skilled Sr. Business Analyst with a strong background in healthcare insurance and contribution accounting.
• This role involves hands-on consulting to assess, strategize, and implement standardized practices that align with the client’s business goals and regulatory requirements.
• We are seeking a passionate, results-oriented candidate who excels in client interactions and can collaborate effectively with stakeholders to analyze, define, and manage
• requirements for clients or products.
• This person must possess a blend of business and technical savvy;and strong communication skills to collaborate across internal and external stakeholders.
• Experience working in an onshore-offshore delivery model, and managing a small team of offshore resources is a must.

Key Responsibilities:
• Requirements Gathering & Analysis: Collaborate with stakeholders, including business units, technical teams, and clients, to gather and document detailed business requirements for health insurance systems, applications, and processes.
• Business Process Modelling: Analyze current business processes and propose process improvements to optimize efficiency, reduce costs, and enhance service delivery within the health insurance domain.
• Solution Design & Implementation: Work closely with technical teams to translate business requirements into functional specifications, user stories, and system designs,
• ensuring alignment with industry standards and regulatory compliance.
• Testing & Quality Assurance: Support the testing process by ensuring business requirements are correctly implemented, validating system functionality, and conducting user acceptance testing (UAT).
• Training & Support: Provide training to team, prepare workflows, and process changes.
• Support the client through post-implementation phases.
• Stakeholder Engagement: Serve as the primary point of contact between the client and development teams to ensure all requirements are fully understood and addressed in
• system designs and solutions.
• Continuous Improvement: Identify opportunities for process and system improvements within the organization and recommend actionable solutions for better health insurance service delivery.
• Onshore-Offshore Model Collaboration: Work effectively with both onshore and offshore teams to manage project delivery, ensuring seamless communication,
• coordination, and alignment across time zones to meet project milestones and deadlines.

Required Skills and Qualifications:
• Experience: 12-15 years of experience as a Business Analyst in the health insurance systems and billing/payment systems.
• Technical Skills: Proficiency in business analysis tools (e.g., SQL/similar programming language, Microsoft Office Suite, Data Import/Export tools).
• Knowledge: Deep understanding of the health insurance landscape, including Contribution Accounting, Billing and Payments, Claims Processing, and System
• Integrations.
• Analytical Skills: Strong problem-solving abilities with a keen eye for detail and a data-driven approach to analysis.
• Communication: Excellent written and verbal communication skills with the ability to present complex concepts to both technical and non-technical stakeholders.
• Collaboration: Proven ability to work cross-functionally with diverse teams, including IT, business operations, external partners, and offshore teams.

Preferred Qualifications:
• Healthcare Certifications: Any relevant certifications in health insurance, healthcare analytics, or related areas
• Contribution Accounting Experience: Familiarity with Contribution Accounting, billing and payment systems

Personal Attributes:
• Strong attention to detail and organizational skills.
• Ability to manage multiple tasks and prioritize effectively.
• Client-focused with a commitment to delivering high-quality solutions.
• Ability to adapt quickly to changing requirements and priorities.

Education:

Bachelor’s or Master’s degree in Business, Information Systems, Healthcare Management, or related field