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Business Analyst

Tanisha Systems, Inc.

Santa Clara, California • Today

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Full-time

$130000 - $150000

Business Analyst

Bayside Solutions

Dublin, California • Today

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Contract

$60 - $65 per hour

Business Analyst

Vidorra Consulting Group

Foster City, California • Today

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Full-time

Senior Business Systems Analyst

Optima Global Solutions

Hybrid in San Jose, California • 5d ago

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Contract, Third Party

$100 - $110

Business Analyst

Wise Skulls Corp.

Hybrid in Sunnyvale, California • 2d ago

Easy Apply

Contract

Depends on Experience

Business Analyst

MSYS Inc.

Remote • Yesterday

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Contract

Depends on Experience

Business Analyst

HCM Staffing and Consulting

Remote • 2d ago

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Contract

$60 - $70

Project Manager / Business Analyst

Tanisha Systems, Inc.

Santa Clara, California • 28d ago

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Full-time

Depends on Experience

Business Analyst

Solomons International

Remote • Yesterday

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Contract, Third Party

Depends on Experience

Business Analyst

HonorVet Technologies

Remote • Yesterday

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Third Party, Contract

$44 - $46

Business Analyst

Innosoul inc

Remote • 5d ago

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Contract, Third Party

Depends on Experience

SAP Controlling Business Analyst (Product Costing)

Maxonic, Inc.

Pleasanton, California • 22d ago

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Full-time

Depends on Experience

Business Analyst

Spruce Technology Inc.

Remote • 5d ago

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Contract

Depends on Experience

Urgent Need - Business Analyst III/Design Program Manager - Remote

Russell, Tobin & Associates

Hillsborough, California • 23d ago

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Third Party, Contract

Depends on Experience

Senior Business System Analyst(Claims)

RIIASH LLC

Remote • 2d ago

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Contract, Third Party

60 - 63

DuckCreek Technical Business Analyst- Remote

The Dignify Solutions, LLC

Remote • Yesterday

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Contract, Third Party

Depends on Experience

Business Analyst

DatamanUSA, LLC

Remote or Salem, Oregon • Today

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Full-time, Part-time, Contract, Third Party

USD 1-1

Business Analyst

Ledgent Technology

Remote • Today

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Contract

$43.64 - $52.58 per hour

Business Analyst

Sunrise Systems, Inc.

Remote • Today

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Contract

$68 - $73

Business Analyst

Eliassen Group

Remote or Almont, Colorado • Today

Contract

Business Analyst

Asterism IT Solutions

Remote • 16d ago

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Contract

50 - 65

Business Analyst - Phoenix, AZ(Remote) || Need local to AZ - F2F Interview

HUMAC INC.

Remote • 14d ago

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Third Party, Contract

Depends on Experience

Senior Business Analyst

NTT DATA Americas, Inc

Remote • 14d ago

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Contract, Third Party

$55 - $66

Senior Business Analyst (Medicaid)

RIIASH LLC

Remote • 5d ago

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Contract, Third Party

60 - 62

BUSINESS ANALYST

AaraTechnologies Inc

Remote or Hybrid in Texas City, Texas • 7d ago

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Contract

$65,000 - $75,000

BUSINESS ANALYST

AaraTechnologies Inc

Remote or Hybrid in Texas City, Texas • Today

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Contract

$65,000 - $75,000

BUSINESS ANALYST

AaraTechnologies Inc

Remote or Hybrid in Virginia Beach, Virginia • Yesterday

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Contract

$65,000 - $75,000

BUSINESS ANALYST

AaraTechnologies Inc

Remote or Hybrid in Virginia Beach, Virginia • 8d ago

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Contract

$65,000 - $75,000

Healthcare Business Analyst Health Plan

People Force Consulting Inc

Remote • Today

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Contract, Third Party

BUSINESS ANALYST

AaraTechnologies Inc

Remote or Hybrid in Washington, District of Columbia • 9d ago

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Contract

$65,000 - $75,000

Job Details

Skills

BUSINESS ANALYST

Summary

Business Analyst
Kennesaw, GA 30144 (Onsite)
Full-Time / Direct-Hire / FTE
Salary – Market- DOE

Experienced Business Analyst with strong health insurance and stop-loss expertise, responsible for partnering with Product Owners, SMEs, and stakeholders to translate claims and eligibility processes into clear, versioned, and testable business rules. Ensures proposed solutions align with business requirements, proactively identifies gaps and discrepancies, and enables engineering teams to build accurate, scalable solutions.

10 years of experience as a Business Analyst on data or US health Insurance domain experience
7 years of experience in US Health Insurance, Stop-Loss, TPA, Payer, Claims, or Data Platform programs
10+ years in requirements management, stakeholder engagement, business process analysis, and backlog refinement
5+ years defining complex business rules, eligibility criteria, rule catalogs, and data governance requirements
5+ years in claims data quality, reconciliation, duplicate detection, record matching, and entity resolution
Strong ability to identify requirement gaps, resolve conflicting business rules, and drive consensus across stakeholders
5+ years partnering with Product Owners, SMEs, Development, QA, and Project Managers to deliver business outcomes and ensure solution alignment
MBA or Any Bachelors degree with extensive experience in Business Analysis

The Business Analyst is the bridge between stakeholders and technical delivery teams, ensuring that the Claims Management Platform is not preferred implemented but also aligned with regulatory, operational, and analytical needs. In a highly regulated environment, success depends on translating complex functional, non-functional and regulatory requirements into actionable, compliant solutions. It ensures regulatory confidence by embedding HIPAA requirement. It drives operational efficiency by reducing manual data transfers, enabling secure vendor collaboration, and standardizing workflows. Enables analytics readiness by defining requirements for dashboards, scorecards, and validated pipelines in Microsoft Fabric and Power BI. Fosters stakeholder alignment by facilitating workshops, UAT sessions, and milestone sign-offs.

Job / Role Description

Write and maintain the rule set that governs how claims data is cleaned, standardised, and combined — including how corrections, reversals and duplicate claims are handled
Own the project backlog. Work with customer Product Owner, stakeholders, SMEs, and WinWire team to iteratively refine the backlog to ensure it meets the customer requirements
Collaborate with WinWire Project Manager to identify and escalate scope creep and schedule/timeline risks
Define the rules for deciding whether two records describe the same person, and where the system should stop and ask a human
Define the eligibility rules: what information is required for each type of member, where the system should look for it internally before asking the provider, and what triggers a follow-up
Facilitate regular working sessions with business and claims SMEs to align on requirements, validate business rules, and ensure timely decision-making
Perform gap analysis between documented requirements, current-state processes, and proposed solutions, proactively identifying risks, ambiguities, and improvement opportunities
Define baseline operational metrics and success measures to quantify business outcomes, efficiency gains, and platform value realization
Develop clear business requirements, user stories, acceptance criteria, and user acceptance testing (UAT) scenarios in partnership with QA and business stakeholders
Write acceptance criteria and user acceptance test scripts alongside the QA leads
Act as the bridge between business and technical teams, ensuring business needs are translated into scalable, actionable, and well-governed solution designs
Communicate effectively with stakeholders; Use clear verbal, written (emails, documentation), and instant messaging approaches to ensure alignment.
Build and maintain productive relationships across cross-functional teams; Experience working in Agile/Scrum projects with tools like Jira or Azure DevOps
Provide constructive feedback during requirement workshops and be open to stakeholder input
Strong analytical mindset to evaluate process flows; Ability to troubleshoot requirement gaps, compliance risks, and process inefficiencies
Provide regular updates, demonstrate proactivity, and show due diligence in carrying out responsibilities
Stakeholder Management - Skilled in facilitating workshops, UAT sessions, and requirement walkthroughs; Act as liaison between business and technical teams, ensuring clarity and consensus

What Success Looks Like / Expected outcome

Successful delivery and adoption of Phases I of the Claims Management Platform, meeting business objectives, quality standards, and project timelines
Experience with enrollment and eligibility workflows, including COBRA, Leave of Absence, and Coordination of Benefits (COB)
Working knowledge of SQL to validate business rules and analyze data directly; Familiarity with healthcare claims and member eligibility processes
Exposure to data migration, data transformation, and data quality initiatives within healthcare or insurance domains

Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.

Dice Id: 10117909
Position Id: 26-19826
Posted 11 hours ago

Fitment

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Data Analyst with Healthcare / QNXT experience

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We are seeking to hire a Conversion Data Analyst with expertise in Medicare / Healthcare Claims systems, to join our teams working on a new multi-year awards we have within several State Govt clients, modernizing their Medicare/Medicaid systems. These roles are 100% remote. Being a US Cit is required for working on this program. This position pays a strong salary package with full benefits (including choice of healthcare plans, dental, vision, life insurance, 3 weeks PTO, 11 Paid Federal Holida

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Job Details

Skills

BUSINESS ANALYST

Summary

10 years of experience as a Business Analyst on data or US health Insurance domain experience
7 years of experience in US Health Insurance, Stop-Loss, TPA, Payer, Claims, or Data Platform programs
10+ years in requirements management, stakeholder engagement, business process analysis, and backlog refinement
5+ years defining complex business rules, eligibility criteria, rule catalogs, and data governance requirements
5+ years in claims data quality, reconciliation, duplicate detection, record matching, and entity resolution
Strong ability to identify requirement gaps, resolve conflicting business rules, and drive consensus across stakeholders
5+ years partnering with Product Owners, SMEs, Development, QA, and Project Managers to deliver business outcomes and ensure solution alignment
MBA or Any Bachelors degree with extensive experience in Business Analysis

Write and maintain the rule set that governs how claims data is cleaned, standardised, and combined — including how corrections, reversals and duplicate claims are handled
Own the project backlog. Work with customer Product Owner, stakeholders, SMEs, and WinWire team to iteratively refine the backlog to ensure it meets the customer requirements
Collaborate with WinWire Project Manager to identify and escalate scope creep and schedule/timeline risks
Define the rules for deciding whether two records describe the same person, and where the system should stop and ask a human
Define the eligibility rules: what information is required for each type of member, where the system should look for it internally before asking the provider, and what triggers a follow-up
Facilitate regular working sessions with business and claims SMEs to align on requirements, validate business rules, and ensure timely decision-making
Perform gap analysis between documented requirements, current-state processes, and proposed solutions, proactively identifying risks, ambiguities, and improvement opportunities
Define baseline operational metrics and success measures to quantify business outcomes, efficiency gains, and platform value realization
Develop clear business requirements, user stories, acceptance criteria, and user acceptance testing (UAT) scenarios in partnership with QA and business stakeholders
Write acceptance criteria and user acceptance test scripts alongside the QA leads
Act as the bridge between business and technical teams, ensuring business needs are translated into scalable, actionable, and well-governed solution designs
Communicate effectively with stakeholders; Use clear verbal, written (emails, documentation), and instant messaging approaches to ensure alignment.
Build and maintain productive relationships across cross-functional teams; Experience working in Agile/Scrum projects with tools like Jira or Azure DevOps
Provide constructive feedback during requirement workshops and be open to stakeholder input
Strong analytical mindset to evaluate process flows; Ability to troubleshoot requirement gaps, compliance risks, and process inefficiencies
Provide regular updates, demonstrate proactivity, and show due diligence in carrying out responsibilities
Stakeholder Management - Skilled in facilitating workshops, UAT sessions, and requirement walkthroughs; Act as liaison between business and technical teams, ensuring clarity and consensus

What Success Looks Like / Expected outcome

Successful delivery and adoption of Phases I of the Claims Management Platform, meeting business objectives, quality standards, and project timelines
Experience with enrollment and eligibility workflows, including COBRA, Leave of Absence, and Coordination of Benefits (COB)
Working knowledge of SQL to validate business rules and analyze data directly; Familiarity with healthcare claims and member eligibility processes
Exposure to data migration, data transformation, and data quality initiatives within healthcare or insurance domains

Dice Id: 10117909
Position Id: 26-19826
Posted 11 hours ago

Fitment

Dice Job Match Score™

🔢 Crunching numbers...

Create job alert

Never miss an opportunity! Create an alert based on the job you applied for.

Similar Jobs

Lead Data Analyst

San Francisco, California

•

Today

Full-time

USD 137,500.00 - 171,875.00 per year

Healthcare Business Analyst Health Plan

Remote

•

Today

Easy Apply

Contract, Third Party

Senior Business Analyst (Medicaid)

Remote

•

5d ago

Easy Apply

Contract, Third Party

60 - 62

Data Analyst with Healthcare / QNXT experience

Remote

•

7d ago

Easy Apply

Full-time

Depends on Experience