Business Analyst

Story Behind the Need

• Business analyst to help with proofing and composition requirements for ID Cards. Availity will add web version of ID cards to be compliant for regulations. Spans across Medicaid, Medicare, Marketplace, etc.

Typical Day in the Role

• Support business initiatives through data analysis, identification of implementation barriers and user acceptance testing of new systems
• Identify and analyze user requirements, procedures, and problems to improve existing processes
• Perform analysis on assigned projects, recommend potential business solutions, and assist with implementation
• Identify ways to enhance performance management related to new business implementation processes
• Develop and incorporate organizational best practices into business applications
• Assist with formulating and updating departmental policies and procedures
• Proof ID card and ID card letter communications for errors
• Create composition requirement documentation and validate data
• Perform various analysis and interpretation to link business needs and objectives for assigned function.

Top 3 must-have hard skills

1

Expertise in MS application (Outlook, Word, Excel, PPT, Teams)

2

SharePoint, Jira

3

Requirements Gathering, UAT/QA, Test Strategy, Documentation, Data

Requirement :

• Bachelors degree
• Years of experience required: 2+ years of business process analysis (i.e. documenting business process, gathering requirements). Experience in healthcare industry or 1+ years of managed care encounters experience
• Additional qualities to look for: Advanced knowledge of Microsoft Applications, including Word, Power Point, Excel and Access. Knowledge of managed care information systems preferred. Understanding of HIPAA transactions (i.e. 837, 999, 824, 277) preferred. Jira, Excel, Outlook, Teams, SharePoint, Project Management, Requirements, Data Analysis & Validation, UAT/QA experience preferred.
• Bachelor's degree in related field or equivalent experience. 2-4 years of business process or data analysis experience, preferably in healthcare. Project management experience preferred.
• Benefits and Payment Configuration
• Compliance Coding/Prepay Compliance (Payment Integrity)
• Bachelor's degree in related field or equivalent experience. 2+ years of business process analysis, preferably healthcare (i.e. documenting business process, gathering requirements) or claims payment/analysis experience. Knowledge of managed care information systems and experience in benefits, pricing, contracting or claims preferred. Knowledge of provider reimbursement methodologies preferred. Previous structured testing experience preferred.
• Encounters:
• Bachelor's degree in related field or equivalent experience. 2+ years of business process analysis (i.e. documenting business process, gathering requirements) experience in healthcare industry or 1+ years of managed care encounters experience. Knowledge of claims and/or encounter processing and data analysis experience preferred. Understanding of HIPAA transactions (i.e. 837, 999, 824, 277) preferred. Knowledge of managed care information systems and experience in SQL scripting preferred.
• Provider Data:
• Bachelor's degree in related field or equivalent experience. 2+ years of business process analysis (documenting business process, gathering requirements) experience in healthcare industry and/or working in a data driven environment. Knowledge of data migration, software enhancement/planning, and Agile preferred.
• Member & Provider Solutions
• Bachelor's degree in related field or equivalent experience. 2+ years of business process analysis (i.e. documenting business process, gathering requirements) experience in healthcare industry and/or customer service or enrollment functions. Experience managing projects with a high reliance on technology. Knowledge of data integration, software enhancements/planning and Agile preferred.

Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad Digital, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad Digital offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).

This posting is open for thirty (30) days.


It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.