BA - Healthcare Specialist

Iconma LLC

  • CA
  • 4 days ago

    Highlights

    Participate in solution implementation, User Acceptance Testing (UAT), and operational readiness activities to ensure successful adoption and transition. Document current-state and future-state processes using process maps, swim lane diagrams, and workflow documentation.

    Numbers & Facts

    LocationCA

    Description

    Our client, a IT Services and Consulting company, is looking for a BA - Healthcare Specialist for their Remote location.

    Responsibilities:

    • Healthcare Business Process Analyst Responsibilities
    • Facilitate Business Process Assessment (BPA) sessions and serve as the BPA lead for one or more SHP project workstreams.
    • Evaluate existing healthcare business processes, operating procedures, and organizational workflows.
    • Conduct process discovery workshops and stakeholder interviews to gather, analyze, and validate business requirements.
    • Document current-state and future-state processes using process maps, swim lane diagrams, and workflow documentation.
    • Identify process bottlenecks, operational inefficiencies, risks, and control gaps, and perform root cause analysis.
    • Recommend and drive process improvements, automation opportunities, standardization initiatives, and corrective actions.
    • Collaborate with business, operations, and technology teams to improve process effectiveness, operational efficiency, and service quality.
    • Present process findings, recommendations, and transformation roadmaps to leadership and key stakeholders.
    • Support digital transformation, business process automation, workflow modernization, BPM, and AI-enabled initiatives.
    • Participate in solution implementation, User Acceptance Testing (UAT), and operational readiness activities to ensure successful adoption and transition.
    • Develop and maintain:
    • Business Process Documents
    • Standard Operating Procedures (SOPs)
    • Workflow Diagrams
    • Business Rules Documentation
    • Decision Trees
    • Process Metrics and KPIs
    • Ensure process artifacts remain current and comply with organizational standards.

    Requirements:

    • Must have Skills: Healthcare Payer
    • Good to have skill: Facets/ ALM experience /Jira
    • Healthcare Domain Knowledge
    • Health Insurance Operations
    • Claims Adjudication
    • Prior Authorization
    • Member Services
    • Provider Network Management
    • Medicare & Medicaid Programs
    • Healthcare Regulatory Requirements

    Why Should You Apply?

    • Health Benefits
    • Referral Program
    • Excellent growth and advancement opportunities

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