Medicare Business Systems Analyst

Job#: 3026145

Job Description:
JOB DESCRIPTION

Job Title: Medicare Business Systems Analyst

100% Remote

Expenses allowed: no

Corewell Health Equipment to be provided.

Job Summary:

We are a large Medicare Advantage (MAPD) health plan undergoing a major core system transformation, migrating from TriZetto Facets to Epic Tapestry effective August 1, 2026. We are seeking an experienced Contract Business Systems Analyst to backfill a key team member during maternity leave and to support critical initiatives during system migration and Annual Enrollment Period (AEP) readiness.

This role will be embedded within our Medicare Business Systems Analyst team and will partner closely with business, IT, and vendor stakeholders to ensure continuity of operations, accurate requirements delivery, and successful testing and implementation during a high impact period.

Essential Functions:

• Serve as a Business Systems Analyst supporting Medicare Advantage operational processes during Epic Tapestry migration and AEP preparation
• Elicit, analyze, and document business and technical requirements related to:
  • Medicare enrollment and eligibility
  • Premium billing and payment processing
  • Member fulfillment (ANOC, EOC, Formularies, Member Letters, etc.)
• Translate business needs into clear functional and technical requirements for development teams
• Collaborate closely with developers and technical teams to clarify requirements, answer questions, and support solution design
• Create, maintain, and execute test cases and test scenarios to validate system changes and ensure business requirements are met
• Support functional testing, integration testing, and user acceptance testing (UAT); document defects and track resolution
• Manage and track work in JIRA, including user stories, acceptance criteria, assumptions, and status reporting
• Develop and maintain process flows and current/future state documentation using Visio
• Support system conversion activities including gap analysis, workflow changes, and operational readiness
• Participate in Agile ceremonies (daily stand-ups, sprint planning, backlog refinement, retrospectives)
• Identify risks, issues, and dependencies related to migration and AEP timelines and escalate as appropriate

Required Qualifications:

• 5+ years of experience as a Business Analyst or Business Systems Analyst in a MAPD Plan
• Strong experience writing, executing, and managing test cases and supporting UAT
• Demonstrates experience working with developers to provide technical and functional requirements
• Strong hands-on experience working in JIRA (user stories, backlogs, sprint tracking, defect management)
• Experience creating process documentation and workflow diagrams using Visio
• Solid understanding of Medicare Advantage operations, including:
  • MAPD Enrollment and eligibility
  • MAPD Premium billing and payment processing
  • MAPD Member fulfillment processes
• Experience working in Agile delivery environments
• Strong analytical, documentation, and stakeholder communication skills
• Ability to operate independently and ramp up quickly in a complex, regulated healthcare environment

Preferred Qualifications:

• Experience with Epic Tapestry (payer platform)
• Prior experience supporting TriZetto Facets/EAM/TCS or similar core administration platforms
• Experience supporting system migrations or large-scale system conversions
• Familiarity with CMS regulations impacting Medicare Advantage operations
• Prior experience supporting Annual Enrollment Period (AEP) activities or peak enrollment cycles

Apex Systems is a world-class IT services company that serves thousands of clients across the globe. When you join Apex, you become part of a team that values innovation, collaboration, and continuous learning. We offer quality career resources, training, certifications, development opportunities, and a comprehensive benefits package. Our commitment to excellence is reflected in many awards, including ClearlyRated's Best of Staffing in Talent Satisfaction in the United States and Great Place to Work in the United Kingdom and Mexico. Apex uses a virtual recruiter as part of the application process. Click for more details.

Apex Benefits Overview: Apex offers a range of supplemental benefits, including medical, dental, vision, life, disability, and other insurance plans that offer an optional layer of financial protection. We offer an ESPP (employee stock purchase program) and a 401K program which allows you to contribute typically within 30 days of starting, with a company match after 12 months of tenure. Apex also offers a HSA (Health Savings Account on the HDHP plan), a SupportLinc Employee Assistance Program (EAP) with up to 8 free counseling sessions, a corporate discount savings program and other discounts. In terms of professional development, Apex hosts an on-demand training program, provides access to certification prep and a library of technical and leadership courses/books/seminars once you have 6+ months of tenure, and certification discounts and other perks to associations that include CompTIA and IIBA. Apex has a dedicated customer service team for our Consultants that can address questions around benefits and other resources, as well as a certified Career Coach. You can access a full list of our benefits, programs, support teams and resources within our 'Welcome Packet' as well, which an Apex team member can provide.