Business Analyst - Technical - Senior
About The Position
Working under general direction, the Senior Business Analyst is responsible for sustaining business processes and processes affected by data and systems. The analyst serves as the central point for system and data interface changes and develops and executes process improvements, reporting, process quality monitoring, vendor relationships, and trading partner exchanges. The role supports business process management, including process modeling, implementation, and assessment. It monitors departmental compliance with government requirements such as CMS, HIPAA, and ACA; assesses business impacts; and manages required performance metrics and data submissions. The analyst participates in standards committees and provides project guidance and training to less experienced users and analysts. As a subject matter expert, the analyst supports project teams and vendors through research, planning, analysis, risk assessment, quality assurance, documentation, communication, and deployment. The position provides project management for large projects, initiatives, and applications, and supports projects and applications during and after implementation, including interface troubleshooting, vendor coordination, issue tracking, customer communication, and incident escalation. The role ensures process and policy accuracy by coordinating user acceptance testing and developing testing protocols, scenarios, and scripts. It gathers and documents business requirements and functional mappings for system enhancements; advises process owners and stakeholders on process improvement; develops and maintains complex queries and reports; and analyzes data across systems to support business intelligence, performance improvement, troubleshooting, cost analysis, and project design. The position may also supervise staff, manage payroll and hiring, handle employee relations, mentor staff, and represent the department in a manager's absence.
Requirements
- Bachelor's degree and four years of experience in health care, health insurance, business analysis, or information systems; the degree must be from an accredited institution and is subject to verification; alternatively, eight years of experience in one or more of those fields.
- Advanced skills with spreadsheets, word processing, and database applications.
- Ability to design and run complex queries and reports.
Nice To Haves
- Experience as a business analyst in pharmacy, pharmacy benefits, PBM, or a related healthcare environment.
- Moderate to advanced SQL skills, including developing queries to analyze, validate, and troubleshoot data across multiple sources.
- Experience with GitHub or similar source-control platforms for managing code, queries, documentation, and development changes.
- Understanding of and experience with API integrations, including interpreting technical documentation and supporting system data exchanges.
- Experience in healthcare or health insurance and understanding of healthcare business processes and data.
- Understanding how healthcare data is produced, consumed, transformed, validated, and exchanged among internal systems, vendors, and external partners.
- Experience reviewing and interpreting regulatory, compliance, and technical documentation and translating requirements into business rules, system requirements, reporting specifications, or operational processes.
- Experience designing, developing, and validating regulatory and compliance reports, including translating written requirements into data elements, business logic, calculations, and report outputs.
- Strong analytical, organizational, communication, and complex problem-solving skills, including investigating issues across business processes, systems, and data.
- Ability to communicate complex business and technical concepts to technical and nontechnical audiences.
- Knowledge of healthcare products and services, contractual requirements, health insurance regulations, and regulatory reporting requirements.
- Ability to collaborate with business stakeholders, developers, compliance and operational teams, vendors, and other technical resources to develop and implement solutions.
Responsibilities
- Participate in business process management, including modeling processes using notations such as BPMN, creating components, implementing processes, and assessing results.
- Monitor departmental contractual compliance with government requirements, including CMS, HIPAA, and ACA; determine business impacts and manage required performance metrics and data submissions.
- Participate in national and local standards committees.
- Provide project guidance and training to less experienced users and analysts.
- Apply knowledge of SDLC methodologies, tools, and techniques for large-sized projects.
- Serve as a subject matter expert for project teams and vendors, supporting research, planning, analysis, risk assessment, quality assurance, documentation, communication, and deployment.
- Provide project management for large-sized projects, initiatives, and applications.
- Support projects and applications during and after implementation, including interface troubleshooting, vendor relations, issue tracking, customer communication, and opening incident tickets with developers.
- Facilitate development and execution of user acceptance test scenarios and scripts for system changes and enhancements, and develop and implement testing protocols and procedures.
- Gather, develop, and document business requirements and functional mapping documents for system enhancements.
- Advise process owners and internal stakeholders on planning and executing process improvements, including suitable strategies, methodologies, and interventions.
- Develop, publish, and maintain complex queries and reports for daily, weekly, monthly, and quarterly use, extracting data from multiple sources.
- Develop business intelligence solutions that turn data into useful information for timely, informed stakeholder decisions.
- Collect, manipulate, and analyze data across systems; assess trends for performance improvement and troubleshoot business or system problems.
- Participate in cost analysis and project and application design.
- May supervise staff, manage payroll and hiring, handle employee relations, mentor staff, and represent the department in a manager's absence.
Benefits
- A comprehensive benefits package described as covering programs to support well-being and a sustainable culture of wellness.
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What This Job Offers
Job Type
Part-time
Career Level
Senior
