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REMOTE Near / Offshore Provider Data Business Analyst

REMOTE Near / Offshore Provider Data Business Analyst

Remote StaffingGates Mills, OH, US
1 day ago
Job type
  • Full-time
  • Remote
Job description

Business Analyst

This BA position is front-end, and does not include back-end responsibilities like SQL querying, UAT testing, system configuration or working with developers. You are expected to build strong relationships with stakeholders and draw out process flows to present to the business, understanding the business flow from step 1, all the way to in the hands of the state.

This candidate is responsible to write epics and features to be passed off to a systems analyst who will write the user stories for the developers to code from.

The company is anticipated to double in size over the next 3 years. There is a lot of opportunity and growth occurring, as well as re-evaluation of existing operations as they expand to new states. You will assist with new market implementation / expansion (how to perform the same functions in new places).

There is still a start-up feel to the company. You have to be comfortable with change, ambiguity, and maturing processes / structure. A task may not be spelled out for you, but the ownness is on the candidate to own their work, take the bull by the horns and do what needs to be done, getting in front of issues by investigating what doesn't feel right, and working without oversight but raising a hand when there is a problem. Things move very fast, so this candidate must take the reins, be influential and drive things forward without instruction / sitting back and waiting for information to come to you. You will work with a PO and PM, but it is on you to manage your own backlog, and to jump right in, finding a way amidst changing asks / potential disorganization. You must be able to look at a Sharepoint document and go off of it yourself, following the bread crumbs and asking the right questions. The business may not know what a process should look like / what they want, but you need to be able to start a project without specifications and make sense of it (understanding, mapping it out, and figuring out the buckets). You will need to be able to conceptualize, organize and sequence a complicated topic, working with the business to chunk it out into logic and package it in business-only epics and features. You will be getting your hands dirty, problem-solving for a grey space by making it black and white and getting everyone to agree on a structure / way forward by defining the big container, and all its pieces and parts.

Other responsibilities include :

  • The business analyst III is responsible for understanding the stakeholder's business rules, culture and priorities to effectively recognize inconsistencies and gaps in complex business processes, identify business problems, assess proposed solutions, and represent the needs of stakeholders
  • Excel in all areas of requirements analysis, leveraging appropriate company and industry approaches and modeling techniques to facilitate requirements elicitations, and gathering requirements for projects in order to document them according to corporate standards and procedures, and prioritize them for assigned areas
  • Provide guidance, recommendations, and mentor other business analysts on approach, guidance, and practices that improve delivery of business requirements and techniques
  • Maintain the group focus, lead meetings toward stated goals and remains impartial in managing group dynamics toward the successful completion of requirements development and management including facilitation of requirements gathering, review, acceptance, prioritization, validation sessions, and decomposition of requirements into work efforts including writing Agile epics and user stories
  • Build, sustain, and leverage professional business relationships when gathering, validating and approving requirements
  • Demonstrate an understanding of stakeholders business culture and priorities, the ability to leverage different techniques used to elicit and capture requirements, EPMO standards for documentation, methods for analyzing and prioritizing requirements, and familiarity with tools enabling tracking and tracing requirements
  • Proficient in all areas of requirements planning, development, and management including planning and monitoring, elicitation and collaboration, requirements lifecycle management, analysis, and validation of business requirements through development of user acceptance test scripts and scenarios
  • Effectively document requirements in all phases of discover through validation; maintain requirements traceability throughout the project and requirements lifecycle
  • Assist the development teams in understanding and elaborating requirements and transitioning them into a comprehensive solution
  • Assist with the preparation and execution of User Acceptance Testing
  • Assist the project manager in developing the requirements phase plan and develop the requirements management plan for area of immediate responsibility
  • If assigned, work with business to develop a business case including return on investment, soft benefits and any regulatory issues
  • Assist the project team in identifying and resolving scope, schedule, and resource issues
  • Assist the project team in performing functional impact analysis and estimating the impact of change requests on timelines, budgets, resources and project scope
  • Identify sources of requirements, possible interfaces and affected lines of business

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity / affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and / or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.

Skills and requirements :

  • 5+ years of Business Analyst experience with business requirement architecture, meeting with stakeholders and eliciting business requirements
  • Ability to write epics, features / user stories, and requirements
  • Agile / Scrum experience, utilizing JIRA or ADO
  • Ability to map out a high level workflow from a stakeholder's concept, and then dig down (ex : business process modeling, process mapping, process flow diagrams, story boards, Visio flowcharts, prototyping)
  • Managed Care Organization / MCO experience with payers like Medicare / Medicaid / Dual Eligibility / D-SNP / Marketplace / Tricare and understanding of CMS guidelines
  • Understanding of the payer / claims lifecycle (Enrollment, Encounters, Prior Authorization / Gold Carding, Eligibility / Benefits Verification, Claim Submission, Adjudication, Payment, Appeals / Grievances)
  • Clear and confident communicator, comfortable jumping in without much oversight or hand-holding, dealing with difficult stakeholders, and working closely with executive leadership / providers
  • Provider Specific : Advanced domain knowledge of provider lifecycle from enrollment to termination (credentialing, contracting, networking, fee schedules, NPI #s etc) Knows what batch files entail, the claims lifecycle and how to reconcile provider data claims with the State so that they are not underpaid
  • New market / vendor / state implementation experience, reviewing RFP / state contract documentation to create new business processes for market expansion and integration
  • Azure DevOps experience
  • Trizetto Facets experience (understanding of the business side of the modules, not of the configuration)
  • Sharepoint experience
  • Agile Certifications such as IIBA, Six Sigma, or ITIL
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    Data Analyst Remote • Gates Mills, OH, US

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