
Lead Healthcare Business Systems Analyst
1 day ago
- Gather, analyze, and document business requirements related to regulatory compliance in the healthcare domain.
- Ensure system changes, processes, and documentation remain compliant with HIPAA, CMS, NCQA, and state-specific regulations.
As a skilled Business Analyst in the Healthcare Domain, you will be responsible for:
Key Responsibilities:
- Collaborate with compliance and legal teams during audits or regulatory updates.
- Analyze and configure benefit codes for medical, dental, pharmacy, and specialty products.
- Support plan design, benefit mapping, and validation in healthcare systems (e.g., Facets, QNXT).
- Coordinate development and validation of member-facing collateral such as EOBs, SBCs, provider directories, and plan brochures.
- Partner with marketing and compliance teams to ensure content accuracy, regulatory alignment, and timely delivery.
- Track versioning and approvals of collateral to maintain consistency across all distribution channels.
Benefits:
- Work collaboratively with cross-functional teams to drive strategic initiatives.
- Opportunity to grow and develop skills in healthcare analytics and policy.
- Contribute to improving healthcare outcomes through data-driven insights and recommendations.
Requirements:
- BA/BS degree in Business Administration, Healthcare Administration, or related field.
- 3+ years of experience in healthcare business analysis, consulting, or related field.
- Strong analytical, communication, and project management skills.
- Ability to interpret and apply complex regulatory requirements.
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