Healthcare Business Systems Analyst

Business System Analyst (Tech Ops)

Lead II - Business Analysis

Who We Are:

UST HealthProof is a trusted partner for health plans, offering an integrated ecosystem for health plan operations. Our BPaaS solutions manage complex admin tasks, allowing our customers to prioritize members' well-being. With our commitment to simplicity, honesty, and leadership, we navigate challenges with our customers to achieve affordable health care for all.

We have a strong global presence and a dedicated workforce of over 4000 people spread across the world.

Our brand is built on the strong foundation of simplicity, integrity, people-centricity, and leadership. We stay inspired in our goal to unburden healthcare and ensure it reaches all, equitably and effectively.

You Are:

HealthProof is searching for a highly skilled and experienced Business System Analyst to join our growing team. The IT Technical Operations Business System Analyst (BSA) will play a key role in planning, coordinating, and streamlining business and functional requirements across customer-facing technology delivery operations, guided by HealthProof's values.

The Opportunity:

* Lead and manage end-to-end business requirements across all stakeholders, ensuring clarity and alignment throughout the implementation lifecycle.

* Drive requirements elicitation sessions with customers, internal teams, product owners, and solution architects.

* Document business and functional requirements across Claims, Enrollment, Provider, Authorization, and Payment systems.

* Translate healthcare business needs into functional and technical requirements, ensuring alignment with HealthProof's core-admin ecosystem.

* Identify customer needs and work with Solution Architects to develop scalable, effective solutions.

This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.

What You Need:

* Bachelor's degree or higher in a business or technical field, or equivalent experience.

* 10 years of experience in business analysis with strong exposure to healthcare payer operations.

* PMP certification preferred

* Deep knowledge of healthcare domains including Medicare, Medicare Advantage, Medicaid, ACA, or Commercial.

* Experience with healthcare payer platforms such as HealthEdge, TriZetto, NASCO, Advantasure, or Change Healthcare.

* Strong experience mapping EDI healthcare transactions including 837, 834, 835, 270/271, 276/277, and 278.

* Experience analyzing and translating business requirements into functional and technical specifications, including TR3/companion guide interpretation.

* Experience with Agile methodologies and tools, preferably Jira or ServiceNow.

* Clear, professional communication skills for working with peers, customers, and partners.

* Experience documenting requirements and user stories and collaborating with technical teams.

* Experience working in an onshore/offshore delivery model is required.

* Understanding of SQL and XSDs is a plus.

* Experience with HealthEdge applications such as HealthRules Payor or GuidingCare preferred.

* Skills & Competencies:

* Communication skills with peers, customers, and partners including the ability to convey information effectively

Compensation can differ depending on factors including but not limited to the specific office location, role, skill set, education, and level of experience. UST HealthProof provides a reasonable range of compensation for roles that may be hired in various U.S. markets as set forth below.

Role Location: Remote

Compensation Range: $80,000-$100,000

Benefits

Full-time, regular employees accrue up to 16 days of paid vacation per year, receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year), 10 paid holidays, and are eligible for paid bereavement leave. They are eligible to participate in the Company's 401(k) Retirement Plan with employer matching. They and their dependents residing in the US are eligible for medical, dental, and vision insurance, as well as the following Company-paid benefits: basic life insurance, accidental death and disability insurance, and short- and long-term disability benefits. Regular employees may purchase additional voluntary short-term disability benefits, and participate in a Health Savings Account (HSA) as well as a Flexible Spending Account (FSA) for healthcare, dependent child care, and/or commuting expenses. Certain regular employees may have the potential for quarterly incentive-based bonuses and or commissions depending on role. Benefits offerings vary in Puerto Rico.

Part-time employees receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year) and are eligible to participate in the Company's 401(k) Retirement Plan with employer matching.

Full-time temporary employees receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year) and are eligible to participate in the Company's 401(k) program with employer matching. They and their dependents residing in the US are eligible for medical, dental, and vision insurance.

Part-time temporary employees receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year).

All US employees who work in a state or locality with more generous paid sick leave benefits than specified here will receive the benefit of those sick leave laws.

What We Believe

At UST HealthProof, we envision a bold future for American healthcare. Our values are the bedrock beliefs our organization holds dear. They not only define what our brand stands for but also serve as a compass guiding every action and decision.

Guiding Principles

These principles illuminate the path of 'how' we operate. They detail actions and behaviors we much embody to honor our values and achieve our goals.

* Simplicity

Simplifying complexity underlines everything we do-this approach is what makes us unique. We come with an open mind and straightforward approach, cutting our way to the core with measurable and actionable insights.

* Integrity

Integrity is our currency to build relationships. We believe in being open and honest. It is only natural when we have nothing to hide. It demonstrates that we are here to do the right thing, no matter who is watching.

* People-Centricity

Everything that we do reflects our deep bonds with peers and customers. These aren't mere transactions, but transformational ties. They shape our culture and decisions, affirming that our true value lies in the lives we touch and impact.

* Leadership

Taking ownership is about taking initiative, being in-charge and driving things to completion. It's a brave choice to 'own' all aspects of our work, ensuring we take full responsibility for everything we handle.

Mission

A future possible only when health plans are free from administrative burdens so they can truly focus on what matters more - their members' well-being.

Equal Employment Opportunity Statement

UST HealthProof is an Equal Opportunity Employer.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other applicable characteristics protected by law. We will consider qualified applicants with arrest or conviction records in accordance with state and local laws and "fair chance" ordinances.

UST HealthProof reserves the right to periodically redefine your roles and responsibilities based on the requirements of the organization and/or your performance.

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Us Healthcare,Business Analysis,Healthcare Payor,EDI Healthcare