Healthcare Business Systems Lead - REMOTE

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Senior Healthcare Business System Analyst - REMOTE. In this role, you will play a crucial part in transforming healthcare administration by effectively capturing business requirements to support health plan operations. You will collaborate closely with various stakeholders to ensure that every aspect of the core-admin ecosystem is optimized for efficiency and clarity.

This position is pivotal in driving positive health outcomes and ensuring that healthcare services remain accessible and affordable. Join us in making a meaningful impact on the healthcare landscape, as you leverage your analytical skills to improve processes and systems for our clients.

• Lead business requirement conversations with customers and internal teams.
• Manage end-to-end requirements involving all stakeholders.
• Develop business and functional requirements for Claims, Enrollment, Provider, Authorization, and Payment systems.
• Create solutions to improve current business processes using core-admin ecosystem.
• Negotiate with clients to develop applicable processes.

• Bachelor's degree or higher in a business or technical field.
• 7+ years of relevant work experience in business analysis.
• Knowledge of Healthcare insurance domain (Medicare, Medicaid, etc.).
• Experience with mapping EDI healthcare transactions (837, 834, 835, etc.).
• Ability to translate business requirements into technical requirements in EDI.
• Experience documenting requirements or user stories for technical teams.
• Experience in onshore/offshore model is essential.
• Familiarity with Health Edge applications is a plus.
• Understanding of SQL and XSDs is advantageous.
• Proficient in Agile tools and methodologies.

• Accrue up to 16 days of paid vacation per year.
• Receive 6 days of paid sick leave each year.
• Enjoy 10 paid holidays annually.
• Eligible for paid bereavement leave.
• Participate in a 401(k) Retirement Plan with employer matching.
• Eligible for medical, dental, and vision insurance.
• Receive Company-paid life, disability, and accidental death benefits.
• Ability to purchase additional short-term disability benefits.
• Potential for quarterly incentive bonuses depending on the role.

We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.

We appreciate your interest and wish you the best!

Data Privacy Notice:
By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.

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