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Healthcare Analyst

SaveSoft, Inc
Charleston, South Carolina, United States
July 23, 2019


Business Analyst (Healthcare Domain)

Position Overview:

This position will act as a liaison between business users and technology staff to identify, prioritize, and complete systems projects for the assigned areas of responsibility. This position is focused on the healthcare claims adjudication for Medicaid. Responsibilities include completion of assigned projects of medium to high complexity through utilization of a standard system development life cycle methodology, to include requirements elicitation and analysis, business design, requirements traceability, participation in testing strategies, test reviews, defect resolution, and post-production follow-up. The Business Analyst role must build, demonstrate, and maintain a detailed knowledge of the business functions, processes, and controls in place within the assigned area of responsibility from an end-user point of view and must be able to bridge business needs with system capabilities needed to support these business needs.


• Maintain an understanding of current business issues, objectives, and strategies within assigned business area and recognize issues and opportunities to optimally apply technology to enhance existing or build new business capabilities.

• Work directly with the business user to formulate and define project scope and objectives that encapsulate end-user business needs

• Participate in the elicitation, documentation, analysis, and validation of business processes, systems, and requirements

• Translate high level business requirements into proper detailed requirements specifications using high maturity methods, processes, and tools

• Work with other Business Analysts to ensure that business design is cohesive across all business areas impacted

• Develop as-in and to-be business process models

• Support requirements management and change management processes

• Ensure that all relevant business documentation is updated in a timely and accurate manner

• Support technical teams to ensure that business requirements are appropriately and comprehensively translated into solid technical designs

• Support testing team to ensure that test plans and test cases comprehensively address business requirements

• Effectively communicate project status, risks, issues, and constraints to project management

Essential Skills:

• Experience with healthcare claims adjudication including benefits design, provider contracting configuration, and fee schedule maintenance.

• Experience eliciting requirements for changes to healthcare claims processing rules

• Bachelor’s degree with an analytical focus (Computer Science, Finance, Math, Economics, etc.)

• Excellent verbal and written communication skills with a demonstrated ability to successfully interact with a diverse group of professionals across all levels of an organization

• Ability to think both broadly and at a detailed level

• Excellent organizational skills

• Strong presentation skills

• Strong critical thinking skills

• Ability to work collaboratively within and across teams

• Ability to work independently under general direction of project leadership

• High tolerance for ambiguity matched with desire to organize it

• Demonstrated ability to drive to results

• Ability to successfully engage in multiple initiatives simultaneously

• Strong working knowledge of Microsoft Office Suite of tools – MS Work, Excel, PowerPoint, Visio