BA - Healthcare Specialist

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