Senior Business Analyst, Enrollment Research & Analytics

Quick Facts

• Role: Senior Business Analyst, Enrollment Research & Analytics (Remote)

• Focus: enrollment operations, member/enrollment data analysis, reporting dashboards, and regulatory compliance

Description

You will provide senior-level business analyst support for complex business requirements related to coverage, reimbursement, and enrollment processing functions. The role analyzes regulatory and functional requirements, documents and maintains them for system changes, and builds reporting/dashboards to support operations. Ultimately, your work helps ensure members have accurate coverage and remain compliant with CMS/state regulations.

Responsibilities

• Develop and maintain requirement documents for coverage, reimbursement, and other applicable system changes

• Monitor regulatory sources and ensure alignment with updates

• Navigate analytical problems and define/document unique specifications

• Identify changes to business processes and propose process development/improvements

• Coordinate cross-functionally with stakeholders and subject matter experts for requirement interpretation and traceability

• Codify requirements for system configuration alignment (where applicable)

• Address requirement interpretation inconsistencies and complaints

• Support standards/best practices and improvement processes to apply requirements across states/products

• Facilitate self-organized reporting so stakeholders understand work efforts and impacts of requirement changes

• Conduct industry research to develop and deploy best practices

• Review compliance-based issues for benefit planning purposes

• Ensure end-to-end business requirements are documented and interpretation is agreed upon

• Provide training and support to team members

Requirements

• 4+ years operations/analyst experience in a managed care organization/health insurance or related field

• In-depth business analyst experience within a Managed Care Organization, specifically Member Enrollment

• Policy/government and legislative review knowledge

• Analytical and problem-solving skills; ability to synthesize large and complex requirements

• Ability to organize and maintain regulatory data including real-time policy changes

• Self-motivated; initiative to identify, communicate, and resolve potential problems

• Experience creating reporting tools and providing project/process updates

• Familiarity with administration systems

• Ability to work cross-functionally in a highly matrixed organization

• Effective verbal, written, and interpersonal communication with stakeholders at all organizational levels

• Microsoft Office suite and applicable software proficiency

Benefits

Competitive benefits and compensation package.