CAI · 11 hours ago
Senior Business Systems Analyst
United States
Full-time
Remote
Senior Level
7+ years exp
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No H1B
U.S. Citizen Only
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Responsibilities
Perform configuration change management activities related to benefits, business rules, screen design, templates, workflows, provider contracts, and user interface design.
Translate configuration rules, fee schedules, contract terms, provider data code sets, and benefits into system parameters to ensure accurate managed care operations.
Lead or actively participate in project teams as a Subject Matter Expert (SME) on the most complex projects, including cross-functional projects with potential regulatory risk exposure and customer service & financial impacts.
Collaborate with customers on complex issues to understand capability needs, gather project specifications, create business cases, translate high-level business needs into detailed requirements, and ensure quality delivery.
Analyze market trends for competitive insight to correlate into business value statements.
Use functional and organizational knowledge to mentor Associate, Intermediate, and Senior Business Systems Analysts.
Perform hands-on configuration in production and test environments, including incident tracking and resolution, release management, and project management.
Develop policies & procedures in support of standardized and accurate configuration and maintenance.
Stay informed of all health plan contracts and amendments, as well as code sets, fee schedules, and pricing changes made by health plans, CMS, and/or the states’ Medicaid programs.
Identify, document, and resolve risks, defects, and issues.
Qualification
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Required
Bachelor’s degree in Business Management, Information Systems, or a closely related discipline
7 or more years in progressive roles within the Information Technology/Services sectors
3 or more years in progressive roles within Project Management
3 or more years of experience in the Health Insurance/Healthcare Industry
Hands-on configuration experience utilizing HealthEdge HealthRules Payer (HRP)
Knowledge of Medicare & Medicaid programs and their benefits
Proficiency in Agile methodology and Agile project management
Strong analytical, problem-solving, and communication skills
Experience writing queries in SQL, generating reports/dashboards
Preferred
Master's Degree in Business Administration/Management or Information Systems
5 or more years of experience in Process Improvement
Experience working in a SaaS model
Experience with Health Source (previously known as Burgess)
Customer service orientation
Leadership skills
Company
CAI
CAI is a global technology services firm with over 8,700 associates worldwide and a yearly revenue of $1 billion+.
5,001-10,000 employees
Funding
Current Stage
Late StageLeadership Team
Tom Salvaggio
President and CEO
Tony Salvaggio
Founder and CEO
Company data provided by crunchbase
