Sr Business Analyst - OHI

TEKsystems•Virginia Beach, VA

2d•$50 - $55•Remote

About The Position

The Business Analyst will support OHI operations and serve as a bridge between business operations, IT, claims, and UAT teams. This person will be responsible for supporting production operations, identifying and documenting issues, performing root cause analysis, supporting business validation, and ensuring that technology solutions align with business needs. This role is more than a traditional requirements-writing position. The ideal candidate must be comfortable working in a live production environment, handling complex healthcare operational processes, analyzing data, mapping data, and working closely with technical teams to resolve issues. They will also support testing efforts by reviewing test plans, validating UAT outcomes, and providing business sign-off when appropriate. This BSA will be supporting a team dedicated to our client's enrollment support services as part of a major implementation project. As they integrate Avmed for their Medicare and commercial lines of business, this person will be responsible for member fulfillment activities throughout the implementation (specifically member ID cards and member materials). This position requires superb critical thinking skills, attention to detail, communication, and ability to coordinate and interface with cross-functional teams. The Sr. BSA will perform activities that provide business solutions to complex organizational initiatives and should demonstrate an extensive expertise in the claims platform and all interfacing applications, both customized and packaged. This individual should possess a high degree of expertise in the business requirements that support reimbursement policies and methodologies of the organization, as well as perform complex data analysis and draw business conclusions for decision-making. The analyst should consider interdepartmental impact when recommending and implementing solutions. Responsibilities include but are not limited to gathering business requirements, root cause analysis, interpretation of requirements, data manipulation and reporting (SQL, Python), ad- hoc reporting and documentation. In addition, the Sr. Business Systems Analyst will be responsible for managing configuration projects, coaching junior analysts and for preparing metric performance reports for the department. He or she will work with peers in the department to establish realistic project scope, project plans and timelines.

Requirements

Bachelor’s degree required
Approximately 7+ years of experience preferred, but not required
Experience working in healthcare payer operations or claims environments
Ability to communicate production issues clearly to IT and business stakeholders
Experience reviewing and approving test plans
Ability to validate UAT outcomes and provide business sign-off
SQL
Python
Agile
Jira
QNXT
Reporting
Requirements gathering
Business analysis
Data analysis
Claims
Member Enrollment
ID Cards
Member Materials

Nice To Haves

Knowledge of OHI operations is a strong plus
Experience with QNext, the claims payment system, is a definite plus
Familiarity with claims payment processes
Prior experience supporting complex healthcare processes
Experience working with reporting teams or operational reporting needs
Preferred fields may include: Business, Information Systems, Healthcare Administration, Related field