Healthcare Business Systems Analyst

Role description

Business System Analyst (Tech Ops)

Lead II - Business Analysis

Who We Are:

UST Health Proof is a trusted partner for health plans, offering an integrated ecosystem for health plan operations. Our BPaaS solutions manage complex admin tasks, allowing our customers to prioritize members' well-being. With our commitment to simplicity, honesty, and leadership, we navigate challenges with our customers to achieve affordable health care for all.

We have a strong global presence and a dedicated workforce of over 4000 people spread across the world.

Our brand is built on the strong foundation of simplicity, integrity, people-centricity, and leadership. We stay inspired in our goal to unburden healthcare and ensure it reaches all, equitably and effectively.

You Are:

Health Proof is searching for a highly skilled and experienced Business System Analyst to join our growing team. The IT Technical Operations Business System Analyst (BSA) will play a key role in planning, coordinating, and streamlining business and functional requirements across customer-facing technology delivery operations, guided by Health Proof's values.

The Opportunity:

• Lead and manage end-to-end business requirements across all stakeholders, ensuring clarity and alignment throughout the implementation lifecycle.

• Drive requirements elicitation sessions with customers, internal teams, product owners, and solution architects.

• Document business and functional requirements across Claims, Enrollment, Provider, Authorization, and Payment systems.

• Translate healthcare business needs into functional and technical requirements, ensuring alignment with Health Proof's core-admin ecosystem.

• Identify customer needs and work with Solution Architects to develop scalable, effective solutions.

This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.

What You Need:

• Bachelor's degree or higher in a business or technical field, or equivalent experience.

• 10+ years of experience in business analysis with strong exposure to healthcare payer operations.

• PMP certification preferred

• Deep knowledge of healthcare domains including Medicare, Medicare Advantage, Medicaid, ACA, or Commercial.

• Experience with healthcare payer platforms such as Health Edge, Tri Zetto, NASCO, Advantasure, or Change Healthcare.

• Strong experience mapping EDI healthcare transactions including 837, 834, 835, 270/271, 276/277, and 278.

• Experience analyzing and translating business requirements into functional and technical specifications, including TR3/companion guide interpretation.

• Experience with Agile methodologies and tools, preferably Jira or Service Now.

• Clear, professional communication skills for working with peers, customers, and partners.

• Experience documenting requirements and user stories and collaborating with technical teams.

• Experience working in an onshore/offshore delivery model is required.

• Understanding of SQL and XSDs is a plus.

• Experience with Health Edge applications such as Health Rules Payor or Guiding Care preferred.

• Skills &

Competencies:

• Communication skills with peers, customers, and partners including the ability to convey information effectively

Compensation can differ depending on factors including but not limited to the specific office location, role, skill set, education, and level of experience. UST Health Proof provides a reasonable range of compensation for roles that may be hired in various U.S. markets as set forth below.

Role Location: Remote

Compensation Range: $80,000-$100,000

Benefits

Full-time, regular employees accrue up to 16 days of paid vacation per year, receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year), 10 paid holidays, and are eligible for paid bereavement leave. They are eligible to participate in the Company's 401(k) Retirement Plan with employer matching. They and their dependents residing in the US are eligible for medical, dental, and vision insurance, as well as the following Company-paid benefits: basic life insurance, accidental death and disability…