Senior Business Analyst - 0108166

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Senior Business Analyst

Job Description

Reports To Business Analysis Manager

A business analyst acts as a liaison between customer and solution provider.

Supporting the initial activities of a project, a business analyst is responsible for analyzing the business needs of their clients and stakeholders, and transforming these needs into a set of functional and non-functional requirements. These requirements will then guide the design, development, and implementation of a solution addressing the business needs identified. The business solution may include the implementation of new, enhanced, or modified business process, system functionality, system configuration, desk top procedures, and/or training.

Supporting the final activities of a project, a business analyst will assist in the preparation for and implementation of the solution, including providing assistance in validating that the solution satisfies the business requirements identified.

As part of a project team, a business analyst collaborates with many others-current and potential customers, end users, operations staff, business development staff, project and product managers, technical staff including software developers and quality assurance engineers, as well as other analysts.


A Senior Business Analyst (SBA) provides a range of analytical support on a project. A SBA is often responsible for the development several analysis artifacts, and may coordinate the work of other BAs on a project. An SBA is expected to be relatively independent, and will require only a general level of support and guidance from a project lead or project manager.

A SBA will typically assist a project lead in the planning and estimation of the business analysis activities for a project, and subsequently expected an analysis strategy appropriate to the scope, size and complexity of the assigned project.


Perform implementation and configuration activities including analysis, system configuration, and operational support for BPO customers

Provide QNXT expertise in support of configuration for new customers and ongoing support of current customer implementations

Analysis, design, and document business processes, supporting workflows and detailed operational procedures

Develop and recommend operational process improvements in support of BPO internal and external customers

Define and analyze business goals, objectives, needs, processes and requirements for legal/regulatory and production related system changes

Recommend system modification enhancements, new system development and/or business process changes

Gather information by facilitating workshops, conducting interviews, performing research, and shadowing workers

Model business and operational processes and system requirements using use cases, the UML, BPMN, and other appropriate techniques

Communicate results through graphical models, written documents, and presentations.

Provide consulting services to current and potential BPO customers in BPR, gap analysis, and process analysis


1 to 2 years of experience in the Health Insurance industry required, including expertise in:

Managed care, Medicaid, Medicare and/or Commercial health insurance

Health insurance claim processing and operations; and automated workflow processes

Expertise in one or more of the following operational areas

  • Eligibility, coverage, and benefit administration
  • Provider management and reimbursement
  • Group administration, premium billing and medical management

HIPAA transaction and code sets and HIPPA privacy rules as they relate to BPO

Regulatory and productivity issues impacting the health care insurance business

Healthcare consulting


Excellent communication skills; ability to convey detailed information to a various business and technical audiences at all levels within an organization

Strong analytical and problem solving skills

Able to work comfortably in a multidisciplinary, collaborative, team environment; yet equally able to work independently in a self directed manner

Understanding of the Software Development Life Cycle, including knowledge of JAD, Scrum, and Agile techniques, with emphasis on the activities of the Inception and Elaboration phases preferred

Some technical aptitude required; ability to formulate SQL queries desired


At least 5 - 8 years of relevant professional experience required

Experience in Managed or Commercial Health Insurance industry required

Experience with a automated claims processing platform required

Experience with Trizetto's QNXT suite of tools strongly desired

Business analysis experience - 3 to 4 years of experience required

  • Requirements Specification - 1 to 2 experience required
  • Analysis modeling using the UML or BPMN (or equivalent) - some experience required
  • Use Case Analysis - some experience required

Able to travel up to 50% of time during BPO implementations


Bachelor's degree in Business, Computer Science or equivalent education and work experience is required 

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