Data/ Senior Business Systems Analyst (Health Care Payor)

Position Title: Data/ Senior Business Systems Analyst Health Care Payor Domain

Location: Hybrid, PHL Area

Employment Type: Contract to Hire

Experience Level: 9+ years

About the Role

Seeking a Data/ Business Systems Analyst Senior with strong techno functional experience in the healthcare payor domain to lead data initiatives. The ideal candidate will have expertise in Payor data and processes like Claims, Population Health and payor data standards. The Business Systems Analyst Senior will have strong education and experience in data tools and technologies including SQL and Oracle. Additionally, you will analyze data files for ingestion and write functional requirements supporting the SDLC and Agile lifecycle from initiation, design, testing, and deployment. A strong analytical background and experience in the healthcare insurance industry is required.

Key Responsibilities

Leadership & Strategy

• Ability to assess, identify and articulate business need for technical and datasolutions.
• Establish data quality SLAs, metrics, and dashboards for business-critical datasets.
• Assists in managing large scale projects, leads appropriate resources and determines project requirements and deliverables, to ensure successful implementations to meet our standards

Data Analysis and Delivery

• Create Documentation like Functional specifications and source to target mappings.
• Advanced SQL skills for data analysis and profiling
• Validate payer data, including claims, membership, provider, and clinical datasets.
• Collaborate with Azure Data Factory (ADF), Databricks, and Snowflake engineering teams to ensure end-to-end data delivery
• In depth understanding of ETL technologies from a BSA perspective.
• Work with data governance and business teams to resolve data quality issues.
• Participates in estimation efforts to formulate and define the scope of IS team deliverables.
• Participates in the change management process playing a lead role as needed.
• Resolves conflicting/competing needs from different areas of the business, tactfully, and in a way that satisfies all parties.
• Ability to manage concurrent multiple tasks and projects; excellent writing and communication skills.

Required Qualifications

Education:

• Bachelor s or Master s degree in Computer Science, Data Engineering, or related field.

Experience & Skills:

1. At least Nine (9) years of experience in a business environment with business/ data analysis, project management, and process re-engineering concentration.
2. Strong expertise in Azure Databricks (Delta Lake, Delta Live Tables, Unity Catalog).
3. Strong SQL skills with ability to create and build queries.
4. Knowledge of data governance, PII compliance, and data quality frameworks.
5. At least five (5 )+ years of experience in Healthcare industry (Medicaid, Medicare)preferred.
6. Strong communication and leadership abilities for cross-functional teamwork.
7. Serves as a SME for all components of a major system, understanding how the information is used and how the system(s) may need to be adapted to changes in business processes.
8. Possess strong understanding prior experience in Healthcare Systems like FACETS (required)
9. Prior experience in EDI data transactions and/ or Care Management data standards
10. Familiarity with BI tools (Power BI, Tableau) to validate reporting layer data
11. Understanding of data governance platforms (e.g., Collibra)
12. Familiarity with industry standard deliverables like RTM, FMEA, Business process mapping etc. is preferred