What are the responsibilities and job description for the Senior Business Systems Analyst (Healthcare Payer COB SME) position at People Force Consulting Inc?
- 18 years of overall Business Analysis experience with 10 years focused on Healthcare Payer operations and at least 7 years in Coordination of Benefits (COB), Eligibility, Enrollment, and Member Data Management domains.
- Deep domain expertise in:
- Coordination of Benefits (COB)
- Primacy Determination
- Enrollment & Eligibility
- Medicare Secondary Payer (MSP)
- Medicaid Coordination Rules
- NAIC COB Guidelines
- Healthcare Payer Operations
- Member Matching / EMPI
- Provider and Payer Ecosystems
- Strong SQL and data analysis capabilities.
- Experience analyzing complex healthcare datasets.
- Familiarity with Azure-based data platforms and modern cloud ecosystems.
- Understanding of API-driven architecture and microservices.
- Hands-on experience with HL7 and FHIR standards.
Business Analysis Skills
- Expert in requirements elicitation and stakeholder management.
- Strong process modeling skills (BPMN, Visio, Lucidchart, etc.).
- Experience working within Agile/Scrum and SAFe delivery models.
- Strong documentation and communication capabilities.