Overview
Remote
$80,000 - $110,000
Full Time
Skills
medicare
Job Details
Job Title: Business Analyst Healthcare (Medicare/Medicaid, Utilization/Care/Disease Management)
Location: Remote
Job Type: Full-Time
Overview:
We are seeking a skilled Business Analyst with experience in Medicare/Medicaid programs, specifically in Utilization Management, Care Management, or Disease Management. The BA will serve as a critical liaison between business stakeholders and engineering teams, ensuring clear requirements, aligned processes, and successful delivery of healthcare solutions.
We are seeking a skilled Business Analyst with experience in Medicare/Medicaid programs, specifically in Utilization Management, Care Management, or Disease Management. The BA will serve as a critical liaison between business stakeholders and engineering teams, ensuring clear requirements, aligned processes, and successful delivery of healthcare solutions.
Key Responsibilities:
- Act as a liaison between business stakeholders and technical teams to define requirements, map processes, and support solution delivery.
- Elicit, analyze, and document business requirements (BRDs/FRDs) and create user stories for Agile/Scrum teams.
- Manage backlog, run grooming sessions, and ensure alignment with regulatory and operational needs in Medicare/Medicaid programs.
- Map and optimize business processes related to Utilization Management, Care Management, or Disease Management workflows.
- Support UAT, coordinate with product and engineering teams, and resolve requirement gaps.
- Use tools such as Jira or Azure DevOps for backlog management and workflow tracking.
- Document processes, support testing, and assist senior BAs in delivering high-quality solutions.
- Collaborate with cross-functional teams to define end-to-end processes, influence product roadmap, and ensure compliance with healthcare regulations.
- Mentor junior BA team members and contribute to enterprise business architecture and governance of requirements.
Skills & Qualifications:
- Strong experience in Medicare/Medicaid, Utilization Management, Care Management, or Disease Management.
- Proficiency in Agile/Scrum methodology and tools (Jira, Azure DevOps).
- Experience with requirements documentation, process modeling, and workflow tools.
- Basic SQL knowledge for data validation and reporting.
- Strong analytical, communication, and stakeholder management skills.
- Ability to lead workstreams, manage acceptance criteria, and drive solutions independently.
- Knowledge of regulatory requirements and operational needs within healthcare programs.
Preferred Qualifications:
- Experience in enterprise business architecture or multi-portfolio analysis.
- Proven ability to mentor and guide junior BA team members.
- Hands-on experience in mapping complex healthcare processes and defining standards.
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