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CareSource

Operations Technical Business Analyst II (payment integrity/CPC nice to have)

Sorry, this job was removed at 12:14 p.m. (MST) on Wednesday, Aug 06, 2025
Remote
Hiring Remotely in USA
62K-98K Annually
Remote
Hiring Remotely in USA
62K-98K Annually

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Job Summary:

The Operations Technical Business Analyst II recognizes inconsistencies and gaps in a complex business process and facilitates scoping and requirements elicitation sessions for projects.

Having a CPC is preferred - Experience with payment integrity, billing and payment methodology. Certified coder and/or coding experience.

Essential Functions:

  • Develop the requirements phase plan and resolves schedule, planning, resource and scope issues according to recommended practices
  • Estimate the impact of change requests on timelines, budgets, resources and project scope
  • Build, sustain, and leverage relationships with persons within his/her area of immediate responsibility when gathering, validating and approving requirements
  • Remain impartial in requirements discussions;  confirms understanding by all parties involved when validating requirements
  • Impartially leads a session to prioritize requirements
  • Gain an understanding of the stakeholder's business culture and priorities, the need for different modeling techniques used when gathering requirements, the corporate standards for documentation, methods for prioritizing requirements and tools for tracking requirements
  • Work with business to develop a business case including return on investment, soft benefits and any regulatory/compliance issues
  • Document effectively in requirements discovery sessions and meetings
  • Identify sources of requirements, possible interfaces and affected lines of business
  • Maintain the group focus, leads the discussion toward stated goals and manages the group dynamics in facilitation requirements gathering sessions
  • Proficient in all areas of requirements elicitation (facilitation, process modeling, requirements documentation)
  • Review vendor supplied user, administration and training documentation for improvements and impacts to our systems and processes
  • Author agile stories and facilitate story grooming sessions for highest priority stories in agile product backlogs, in collaboration with IT and business roles and stakeholders, including product owners, developers, software quality analysts, and requestors
  • Transfer knowledge of story writing and story grooming skills to key roles within IT and business
  • Collaborate with peers and related roles to establish guidelines and recommended practices for story writing and story grooming across the organization
  • Perform any other job related instructions as requested

Education and Experience:

  • Bachelor’s  degree in Computer Science, Information Systems, Business Administration or related field or equivalent years of relevant work experience is required
  • Two to five (2 to 5) years of experience in requirements management  is required
  • A minimum of two to five (2 to 5) years of experience working  in Facets, CCA, SAP, CRMs or other similar enterprise systems is required
  • Experience designing interfaces and/or mocking up user interfaces to support and display the information in multiple UI disciplines (Web, Mobile, Client Server, etc.) is required
  • Familiarity with the healthcare environment (Medicaid/Medicare) is preferred

Competencies, Knowledge and Skills:

  • Proficient in Microsoft Office toolset
  • Thorough understanding of  business analysis principles and available solutions
  • Experience in creating and writing technical specifications within an agile framework: Epics, Story, Task
  • Proven ability to establish effective working relationships with stakeholders at all different levels
  • Knowledge of various software applications/elicitation tools used to facilitate the collaborative and agile development, recording and distribution of requirements to stakeholders
  • Thorough understanding of a project lifecycle coupled with the software development lifecycle, including processes, techniques and tools
  • Proficient in Agile story writing using standard industry formats. 
  • Understands key components of good story writing to enable adaptation of standard industry formats and approaches for effective use within the organization.
  • Highly effective at collaboratively eliciting agile stories from product owners, requestors, agile teams, and other stakeholders. 
  • Highly effective at facilitating agile teams’ story grooming sessions.
  • Experience in continuous delivery software development lifecycles is a plus
  • Excellent written and verbal communication skills
  • Effective identification of business problems, assessment of proposed solutions to those problems, and understanding of the needs of stakeholders
  • Ability to work independently and within a team environment
  • Ability to multi-task and prioritize work to meet project deadlines
  • Effective listening and critical thinking skills
  • Flexibility during organizational and/or business changes
  • Strong interpersonal and relationship building skills
  • Effective problem solving skills with attention to detail
  • Ability to effectively and efficiently work within  a project team
  • Time management skills
  • Customer service oriented
  • Decision making/problem solving skills
  • Ability to develop, prioritize and accomplish goals
  • Coordinate and lead cross-functional teams

Licensure and Certification:

  • CPC is Preferred

Working Conditions:

  • General office environment; may be required to sit or stand for extended periods of time

Compensation Range:

$61,500.00 - $98,400.00

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Salary

Organization Level Competencies

  • Create an Inclusive Environment

  • Cultivate Partnerships

  • Develop Self and Others

  • Drive Execution

  • Influence Others

  • Pursue Personal Excellence

  • Understand the Business


 

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.#LI-GB1

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