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Business Analyst - Health Plan

Company: Brighton Health Plan Solutions
Location: Walton
Posted on: November 22, 2021

Job Description:

Company: Brighton Health Plan Solutions

Job Title: Business Analyst

Department: Information Technology

At Brighton Health Plan Solutions (BHPS), we're creating something new and different in health care, and we'd love for you to be part of it. Based in New York City, BHPS is a rapidly growing, entrepreneurial health care enablement company bringing tangible innovation to the health care delivery systems. Under the Brighton Health Group portfolio with the support of a premier investor group led by Goldman Sachs, our 250-person team is committed to transforming how health care is accessed and delivered. We believe that cost, quality, and population health are optimized when people have long term relationships with their health care providers - and that's why we're creating new products that today do not exist anywhere in the New York/New Jersey market. With a growing labor business under the well-known MagnaCare brand, the launch of Create - a new marketplace of health systems focused on self-insured commercial health plan sponsors, and a successful Casualty business, we're fiercely committed to positively impacting our partners.

Company Mission: Transform the health plan experience - how health care is accessed and delivered - by bringing outstanding products and services to our partners. Company Vision: Redefine health care quality and value by aligning the incentives of our partners in powerful and unique ways.

About this Role: Are you looking to take your career in healthcare to the next level? We are looking for a Business Analyst who will work within the Delivery team. This team will work to determine product planning, portfolio and priorities including managing complex strategic projects/programs spanning multiple areas of business and external partners. A business Analyst with experience working in the healthcare industry and understanding hands on experience in eliciting and defining requirements, workflow and ensuring traceability and delivery in Healthcare Insurance with Business and IT Applications Delivery spanning one or more domains (Eligibility, Claims processing & Reimbursements, Benefits Configuration etc.). This person must possess a blend of business and technical savvy; strong communication skills to collaborate across multiple stakeholders.

Primary Responsibilities: --- Leads analysis for multiple work streams or domains in healthcare insurance business; developing Use Cases, product / business requirements, create and or maintain business and technical requirements leveraging iterative or waterfall methodology to deliver high quality solutions that meet business / market needs. --- Actively participate in gathering and establishing product requirements, workflows and provide expertise for design and UAT for traceability. --- Creates and documents requirements, process flows, functional and technical specifications in user stories, process maps for user experience design, testing and implementation; --- Provides analysis of business implications and applies problem solving skills to meet business needs. --- Creatively translates information using business knowledge and identify additional information needed to support business objectives. --- Interacts with internal/external customers to define information for solution development. --- Develop and integrate the delivery approach, dependencies, resource requirements and schedule for multiple work streams with the overall program and launch schedule; --- Develops detailed timeline, integrates project plans into other release schedules and works to resolve schedule and resource conflicts. --- Participate in the presentation of information to customer and internal business and or IT teams. --- Creates business / product / third party vendor specifications for product integration and implementation. --- Performs gap analysis, Supports implementation and launch of products. --- Manages communications (to stakeholders, leadership, etc.) with project teams and management; could be project plans, status reports and other project related updates/communications. --- Ability to lead cross-functional teams in a matrix environment and develop a shared sense of urgency to ensure project success. --- Work closely with program / project / senior level leadership when necessary, especially in the areas of organization and policy change required for new system implementation.

Essential Qualifications: --- Bachelor's degree or equivalent experience. BA Certifications and or PMP a plus. --- Expertise and experience in preparing Scope & High Level requirements, Use Cases, Business Requirement Documents, Functional specifications, Test strategy & cases and Traceability matrix. --- Proven ability to map business process and workflows, conducting gap analysis and documenting requirements, ensuring requirements are developed and tested. --- Excellent verbal/written communication skills; comfortable initiating conversations with both business and technology leaders within the organization, as well as the ability to translate business issues and requirements into technical solutions. --- Healthcare Insurance Payer industry experience in one of more of the following areas: Eligibility, Claims processing & Reimbursements, Benefits Configuration. --- Strong analytical and problem solving skills; Ability to analyze problems and resolve issues through resolution quickly and methodically. --- Business Analysis; required 6+ years. --- Health Insurance or Benefit Administration business process & systems Implementation; required 3 years. --- Solution Delivery - Requirements through Release Traceability; required 3 years. --- Ability to manage issues, risks and decisions with excellent reasoning judgment --- Excellent verbal and written communication skills. --- Proficient with Word, Excel and PowerPoint, Visio --- Knowledge of BA/ MS project Tools, JIRA, MS Project, Excel, Visio --- Strong Experience with healthcare insurance around Customer portals, Claim & Provider Reimbursements, Clinical, Provider facing Portals & applications --- Self-motivated and detail-oriented --- Flexibility to adapt to change and willing to learn and develop new skill sets as applicable. *We are an Equal Opportunity -Employer

Keywords: Brighton Health Plan Solutions, Scranton , Business Analyst - Health Plan, Healthcare , Walton, Pennsylvania

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