Senior
Business Analyst
1207166
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.
SUMMARY
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.
ESSENTIAL FUNCTIONS
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
HEALTH INSURANCE
DOMAIN KNOWLEDGE and EXPERIENCE
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
GENERAL KNOWLEDGE and SKILLS
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
QUALIFICATIONS
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
EDUCATION
Bachelor's degree in
Business, Computer Science or equivalent education and work experience is required
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