Wise Skulls Hiring for Healthcare Business Analyst at Smithfield, RI Full Time

Location: Rhode Island (HYBRID Schedule- onsite 3-4 days a week)

Duration: 12+ Months (Possibility of Extension)

Implementation Partner: Sierra Solutions Group

End Client: To be disclosed

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Position Overview:

• This position is responsible for the development of business and functional requirements documentation and serves as a subject matter expert in an operational business area.
• He/she acts as a liaison to the operational business areas, coordinates on the requirements efforts of corporate projects.
• He/she might also be responsible for mapping business processes, actively participating in identifying current problems, and recommending business analysis solutions to operational issues.
• This role also requires knowledge of health plan operations including Medicare and Medicaid plans, claims processing, EDI transaction processing, enrollment, financial reconciliation, and IT systems knowledge.
• A successful candidate will possess leadership, communication and strong analytical skills and will be adept in business analysis.

Qualifications/Required

• Bachelor’s degree or equivalent professional experience
• Five (5)+ years of experience in a Managed Health Plan setting
• Five (5)+ years of related business analysis/data analysis experience
• Three (3)+ years of experience modeling business processes
• Exceptional interpersonal abilities with a proven record of influencing and negotiating at all management levels.
• Capable of engaging with a diverse stakeholder group including business users, developers, and senior management.
• Strong communication skills, both verbal and written
• Exceptional time management and organizational capabilities
• Experience in creating comprehensive business requirements and end-user documentation.

Preferred

• Extensive experience in an insurance, medical, or HMO environment using claims processing systems.

Duties And Responsibilities

• Act as a key resource in gathering, coordinating, and documenting business requirements and test cases for corporate projects.
• Lead business analysis for project initiatives and ongoing process enhancements
• Drive the development and documentation of processes for new or modified business functionalities.
• Analyze root causes and resolve complex operational issues.
• Understands operational processes within the business area.
• Identifies and advocates for opportunities to bring value/improvements to the business area.
• Documents key workflows within the assigned business department.
• Applies industry-specific expertise to recommend and coordinate the development, enhancement, and maintenance of a department’s business systems, processes, and products.
• Combines industry expertise with a thorough understanding of information technology to develop innovative business solutions. Influences the strategic direction of the support department(s).
• Manage large-scale project analyses, requirements, and change processes.
• Encourage and lead process improvement efforts and the training of peers and colleagues.
• Estimate resources and timelines for project deliverables.
• Collaborate with stakeholders to define business requirements and project scope.
• Translate stakeholder needs into technical specifications and vice versa.
• Validate requirements with stakeholders and draft use cases for requirement documents.
• Identifies potential areas of automation and aid in re-engineering underlying business processes.
• Assists in developing and maintaining standards for development of business processes and documentation.
• Coordinates multiple simultaneous projects and initiatives.