Sr Business Analyst

The Senior Business Analyst will be responsible for leading the analysis, documentation, and management of business requirements throughout the project lifecycle. They will be required to liaise between the business and technical teams to ensure business goals are achieved by providing innovative and effective solutions. 

Responsibilities

• Review, analyze and evaluate business systems and user needs
• Document requirements, define scope and objectives and formulate systems to parallel overall business strategies
• Interact with stakeholders to understand their business objectives and translate them into operational improvements and software system requirements
• Performs feasibility analysis, scopes projects, and works with the project management team to prioritizes deliverables, and negotiate on product functionalities
• Create detailed Business Requirement Document (BRD) and translate it into functional specifications
• Provide analytical support for project teams, including data collection, trend identification, data visualization, and result interpretation
• Analyzes, recommends and implements requirements changes or improvements to service levels, production, staffing, volume, policies and procedures, user-based systems, financial, audit, compliance, quality, and urgent operations problem resolution.
• Solve complex problems; takes a new perspective on existing solutions; exercises judgment based on the analysis of multiple sources of information.
• Develop advanced knowledge and considered a resident expert of a business organization, operating processes, user-based systems, and any governing policies and regulations over such programs.
• Leadership skills to lead project teams and collaborate with peers and assist with their needs; analysis, project specifications, and solutions development of an internal/external customer's business challenges.

Essential Duties

• Serve as a product expert for the PPO area including PPO partner and customer relationships.
• Coordinate with Bill Review team and Compliance to be informed and aware of all regulatory and compliance requirements affecting the PPO product area.
• Confirms and ensures efficient and effective technical integration of PPO products with core application functionality and architecture.
• Ensures product delivery, product quality and product innovation for the PPO area on time.
• Leads product design, development, and prioritization for release deployment of the PPO product(s) and assists with maintaining a product development road map.
• Acts as a point of escalation for assigned PPO issues.
• Produces business requirement documents which define, justify and prioritize product initiatives.
• Reviews business requirements, use cases and guidance for PPO product implementations/enhancements.
• Facilitate project team meetings and monitoring of status.
• Engages with Development and Quality Assurance on an ongoing basis to develop strategies and execution plans for the PPO product.
• Leads the implementation processes of PPO vendors, client implementations and/or PPO Projects during release cycles and manage/coordinate with QA the overall testing from start to finish.

Qualifications

• PPO product experience in one or more of the following: workers’ compensations bill review, claims management, medical billing, PPO or MCO Networks, general healthcare industry, Medicare, specialty review network, and/’or related software product experience.
• Experience as a Business Analyst or similar role in business operations
• Technical experience with SQL Database, Electronic Data Interchange (EDI), and ANSI 5010 837 transactions, and Web Service API is preferred
• Strong knowledge of software development lifecycle (SDLC)
• Knowledge of business process modelling and reengineering
• Strong communication and presentation skills
• Proficient in Microsoft Office Suite and business analysis software