Senior Business System Analyst

Jobgether

3d • $100,000 - $125,000 • Remote

About The Position

This role offers a unique opportunity to shape and optimize healthcare business processes by bridging business needs with technical solutions. You will lead end-to-end requirements gathering, functional design, and solution implementation for complex health plan systems, working closely with internal teams, clients, and vendors. The position involves analyzing claims, enrollment, provider, authorization, and payment workflows to ensure accurate and efficient system configurations. You will play a key role in driving automation, improving process efficiency, and supporting strategic initiatives that impact multiple stakeholders. The ideal candidate thrives in a collaborative, hybrid work environment, is highly analytical, and enjoys delivering scalable solutions that directly influence operational excellence and customer satisfaction.

Requirements

• Bachelor’s degree or higher in business, technology, or a related field.
• 12+ years of experience in business analysis, with deep knowledge of healthcare payer domains (Medicare, Medicaid, ACA, commercial insurance).
• Experience with healthcare ecosystems and core-admin platforms such as HealthEdge, TriZetto, NASCO, Advantasure, or Change Healthcare.
• Strong expertise in EDI healthcare transactions (837, 834, 835, 270/271, 276/277, 278) and mapping requirements to technical solutions.
• Experience documenting requirements, user stories, and functional specifications; effective communication with technical and non-technical teams.
• Familiarity with SQL, XSDs, Agile tools, and Scrum methodologies is a plus.
• Ability to work in a hybrid/remote model across multiple time zones and manage onshore/offshore collaboration.
• Exceptional analytical, problem-solving, and stakeholder management skills, with strong attention to detail.

Nice To Haves

• Familiarity with SQL, XSDs, Agile tools, and Scrum methodologies is a plus.

Responsibilities

• Lead business requirement discussions with clients, internal teams, and third-party partners to define system needs and processes.
• Develop and document functional and business requirements for claims, enrollment, provider, authorization, and payment systems.
• Translate business requirements into technical specifications, workflows, and user stories for implementation teams.
• Collaborate with solution architects to design scalable, effective solutions within the core-admin ecosystem.
• Support Agile project methodologies, including sprint planning, retrospectives, demos, and go-live evaluations.
• Identify opportunities for automation, performance improvement, and process reusability.
• Conduct requirement walkthroughs and ensure alignment across internal and external stakeholders, including offshore teams.

Benefits

• Competitive base salary ranging from $100,000 to $125,000 per year, dependent on experience and qualifications.
• Fully remote work environment with flexibility to manage your schedule.
• Comprehensive health coverage including medical, dental, and vision plans.
• Paid time off and holidays to support work-life balance.
• Opportunities for professional growth and engagement with complex, high-impact healthcare projects.
• Inclusive and collaborative work culture fostering learning, mentorship, and innovation.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level