出海雷达

业务分析师

Business Analyst

其他限定地区(需当地身份)
公司HealthEdge
薪资$100,000 - $120,000/年
工作地点United States
地域资格限定地区(需当地身份)
时区要求日间重叠约 9 小时,基本正常作息
用工类型Full Time
发布时间12 天前
数据来源Himalayas
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注意地域限制:该职位明确限定在 United States 招聘。如果你是位于中国大陆的求职者,通常需要当地工作身份才能投递,或需与雇主确认是否接受独立合同(Contractor)形式合作。

概述
关于UST HealthProof
在UST HealthProof,你将加入一家快速发展的公司,与我们一同致力于通过大幅降低行政成本,为我们的健康计划客户及其成员打造更优质的医疗体验,从而重塑医疗保险的未来。通过构建现代、基于云的顶级核心管理生态系统,我们让医疗更加可负担,并帮助我们的健康计划更高效地运营。通过减少成员和提供者之间的摩擦点,我们真正对成员产生了影响。
UST HealthProof由拥有强大健康计划和技术背景的领导者运营,具备初创公司的思维和一个支持个人成长的环境。你将支持我们经过验证的核心管理解决方案和业务流程即服务(BPaaS)运营,以实现透明度,提高运营效率,打破运营障碍以实现扩展,并推动战略增长。
业务系统分析师(BSA)将协助收集健康计划客户的核心管理业务功能的业务需求,同时实施UST HealthProof的核心管理生态系统。BSA将与健康计划客户、第三方供应商/合作伙伴、内部产品团队、解决方案架构师和产品负责人合作,定义实施所需的企业规则和流程。
候选人应具备医疗保险公司领域的深入知识和经验(理赔处理、注册、供应商、支付)。他/她应具备出色的需求数取和沟通能力,并能够作为团队的一员,无论是现场还是远程工作。此外,他/她应能够识别客户问题,并与解决方案架构师合作为客户提供解决方案。
作为UST HealthProof的业务分析师,你将负责以下职责:

  • 与客户和内部团队主导业务需求讨论。
  • 管理涉及所有利益相关者的端到端需求。
  • 负责开发理赔、注册、供应商、授权、支付系统的业务和功能需求。
  • 使用UST HealthProof的核心管理生态系统为现有业务流程创建解决方案。
  • 与客户协商,制定符合当前情况的流程。
  • 与业务用户、管理层、IT和海外团队协作,确保最终产品的完成。
查看英文原文

Overview
About UST HealthProof
At UST HealthProof, you will join a fast paced, growing company in our mission to reshape the future of health insurance through significantly reducing administrative costs and building better healthcare experiences for our health plans customers and their members. By creating a modern, cloud based, Best-In-Class core administration ecosystem, we have made healthcare more affordable and helped our health plans operate more efficiently. Through member and provider touchpoints with less friction, we have created real impact for member.
UST HealthProof is run by leaders with strong health plan and technology background with a start-up mindset and an environment of support where individual growth is nurtured. You will be supporting our proven core admin solutions and business process-as-a-service (BPaaS) operations to provide transparency, improve operational efficiency, break down operational barriers to scale and drive strategic growth.
The Business System Analyst (BSA) will help in capturing the business requirements to run the Health plan customer’s Core admin business functions while implementing UST HealthProof’s core-admin ecosystem. The BSA will work with the Health Plan Customers, third party vendors/partners, Internal product teams, solution architects and product owners to define the business rules and processes required for implementation
The Candidate should possess deep knowledge & experience in HealthCare Payor domains (Claims adjudication, Enrollment, Provider, Payment). He / She should have excellent requirement elicitation and communication skills and ability to engage as part of a team working both physically and virtually. Also, he / she should be able to identify the customer problems and work with Solution Architect(s) to provide the solution to customer.
As a Business Analyst at UST HealthProof; you will be accountable for the following:

  • Leading business requirement conversations with customer and internal teams.
  • Managing the end-to-end requirements involving all the stakeholders.
  • Responsible for developing business and functional requirements for Claims, Enrollment, Provider, Authorization, Payment systems.
  • Create solutions for current business processes using UST HealthProof’s core-admin ecosystem.
  • Negotiate with client to develop processes that are current and applicable to the situation.
  • Collaborate with business users, management, IT, and offshore staff to ensure the finish product meets project objectives and client expectations by applying ‘Agile like’ project methodology.
  • Instrumental in analysing the healthcare business requirements and translating them to functional and technical requirements
  • Identify opportunities for automation, performance improvements, reusability.
  • Develop high level workflow diagrams and system context diagrams.
  • Document the understanding of the process flow using swim lanes diagrams.
  • Produce the Requirements plan that aligns with the overall Project Implementation plan.
  • Dictate the risks and dependencies in the timely manner with the Customer to complete the requirement gathering to meet up with the project plan dates.
  • Must work with Offshore Business Analysts to elaborate user stories
  • Conduct Requirement walk through with the customer and internal/external stakeholders
  • Collaborate with the development team & QA team to ensure the finish product meets project objectives and client expectations.
  • Contribute towards sprint planning, retrospective, go-live/no go-live evaluation meetings.
  • Conduct Demo of MVPs for the customer.

You bring:

  • Knowledgeable in Healthcare insurance domain (Medicare, Medicare Advantage, Medicaid, ACA or Commercial).
  • Exposure to healthcare eco-systems from partners like HealthEdge, TriZetto , NASCO, Advantasure or Change Healthcare.
  • Experience with mapping of EDI healthcare transactions (837, 834, 835,270/271, 276/277, 278)
  • Awareness to Agile tools and scrum methodologies.
  • Communication skills with peers, customers, and partners including the ability to convey information effectively.
  • Experience in analysing the business requirements and translating/mapping them to technical requirements in EDI technology by analysing implementation/companion/TR3 guides.
  • Experience documenting requirements or user stories and communicating the requirements to technical teams, partners/vendors or product teams Experience working in an onshore/offshore model is a must.
  • Experience working HealthEdge applications like HealthRules Payor or GuidingCare is a plus.
  • Understanding of SQL, XSDs is a plus.
  • Bachelor’s degree or higher in business or technical field, 10+ years of relevant work experience in business analysis

Geographic Responsibility: Remote, US
Type of Employment: Full-time, permanent
Travel%: up to 25%
FLSA Classification (USA Only): Exempt
Work Environment: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job: 
· The employee is occasionally required to move around the office. Specific vision abilities required by this job include close vision, color vision, peripheral vision, depth perception, and ability to adjust focus.
· Work across multiple time zones in a hybrid or remote work environment.
· Long periods of time sitting and/or standing in front of a computer using video technology.
· May require travel dependent on company needs.
The above statements are intended to describe the general nature and level of the job being performed by the individual(s) assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and skills required. HealthEdge reserves the right to modify, add, or remove duties and to assign other duties as necessary. In addition, reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position in compliance with the Americans with Disabilities Act of 1990. Candidates may be required to go through a pre-employment criminal background check.
HealthEdge is an equal opportunity employer. We are committed to workforce diversity and actively encourage all qualified persons to seek employment with us, including, but not limited to, racial and ethnic minorities, women, veterans and persons with disabilities.
**The annual US base salary range for this position is $100,000 to $120,000. This salary range may cover multiple career levels at HealthEdge. Final compensation will be determined during the interview process and is based on a combination of factors including, but not limited to, your skills, experience, qualifications and education. 
Originally posted on Himalayas

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