Role: Business Analyst
Location: Remote
Experience: 15+ yrs
Note: W2
Serves as the lead business analysis and process-design professional on payer initiatives. He/she discerns business needs, facilitates and elicits requirements, and ensures end-to-end traceability from business intent through delivered solution.
Acting as the lead analyst on assigned initiatives, the Senior Consulting Manager works across multiple efforts simultaneously, validates scope with sponsoring stakeholders, and serves as a SME and quality reviewer for junior analysts.
• Serve as lead business analyst/consultant on payer initiatives, owning requirements quality and end-to-end traceability from intake through validated delivery.
• Facilitate elicitation workshops with SMEs, business owners, and delivery teams to define and refine features and requirements.
• Act as expert advisor/SME for business analysis and process design, and peer-review work produced by junior and associate analysts.
• Partner with the PM, Initiative Owner, and Enterprise Business Architect to validate scope, develop status reports, and manage multiple concurrent initiatives.
Sample Deliverables owned or contributed to:
• Agile Artifacts (Epics, Features, User Stories) and Process Flows
• Business/Functional Requirements Document
• Requirements Quality and approval artifacts
• Requirements Traceability Matrix
• Internal and Client Presentations
• Payer knowledge (required): Hands-on payer expertise in at-least 3 core areas such as claims, membership, Products, provider & network data, care/utilization management, member services, or customer service.
• 15 years in business analysis, process design, or healthcare consulting, including a lead-analyst role on complex initiatives.
• Proven ability to facilitate workshops, elicit requirements from technical and non-technical stakeholders, and manage multiple initiatives independently.
• Strong command of requirements documentation, traceability, and structured delivery methodologies (Agile, Waterfall, hybrid
• Preferred: Working familiarity with generative Al tools and an understanding of agentification (how agentic Al worktlows can automate and augment requirement tasks)
• Preferred: Familiarity with payer regulatory frameworks (CMS, ACA, HIPAA, NCOA, EDI transactions (834, 837, 835, 270/271), and core admin platforms (Facets, QNT, HealthEdge) plus requirements tools (Jira, ADO, ALM).
• Preferred: Certification in AHIP, CAP, or SPO is a plus.
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