Exception Template - 110014 Business Analyst III
"Position Purpose: Perform various analysis and interpretation to link business needs and objectives for assigned function.
Education/Experience:
Bachelor s degree in related field or equivalent experience. 4-6 years of business process or data analysis experience, preferably in healthcare. Project management experience preferred.
Benefits and Payment Configuration:
Bachelor s degree in related field or equivalent experience. 4+ years of business process analysis, preferably in healthcare (i.e. documenting business process, gathering requirements) or claims payment/analysis experience. Experience in benefits, pricing, contracting or claims and knowledge of provider reimbursement methodologies. Knowledge of managed care information or claims payment systems preferred. Previous structured testing experience preferred.
Compliance Coding/Prepay Compliance (Payment Integrity)
Bachelor s degree in related field or equivalent experience. 4+ years of business process analysis (i.e. i.e. documenting business process, gathering requirements). Experience in healthcare industry, preferably with managed care techniques and administrative philosophy. Experience in claims coding analysis or medical claim review/research preferred. Knowledge of Amisys claims payment system and Business Objects preferred.
Encounters:
Bachelor s degree in related field or equivalent experience. 4+ years of business process analysis (i.e. documenting business process, gathering requirements) experience in healthcare industry or 3+ years of managed care encounters experience. Experience with encounters or claims business analysis experience in healthcare, preferably managed care or Medicaid. Knowledge of Amisys or other claims system, HIPAA transactions (i.e. 837, 999, 824, 277) and SQL Scripting preferred.
Medicare
Bachelor s degree in related field or equivalent experience. 4+ years of business process analysis (i.e. documenting business process, gathering requirements). Experience in healthcare industry, preferably with managed care techniques and administrative philosophy. Experience in managed health care experience, preferably with Medicare. Experience working with and leading diverse teams in matrix managed environments. Project management experience preferred.
Provider Data:
Bachelor s degree in related field or equivalent experience. 4+ years of business process analysis (documenting business process, gathering requirements) experience in healthcare industry and/or working in a data driven environment. Knowledge of data migration, software enhancement/planning, and Agile preferred. Experience managing projects with a high reliance on technology.
Member & Provider Solutions
Bachelor s degree in related field or equivalent experience. 4+ years of business process analysis (i.e. documenting business process, gathering requirements) experience in healthcare industry and/or customer service or enrollment functions. Experience managing projects with a high reliance on technology. Knowledge of data integration, software enhancements/planning and Agile preferred.
"Support business initiatives through data analysis, identification of implementation barriers and user acceptance testing of various systems
Identify and analyze user requirements, procedures, and problems to improve existing processes
Perform detailed analysis on multiple projects, recommend potential business solutions and ensure successful implementations
Identify ways to enhance performance management and operational reports related to new business implementation processes
Coordinate with various business units and departments in the development and delivery of training programs
Develop, share, and incorporate organizational best practices into business applications
Diagnose problems and identify opportunities for process redesign and improvement
Formulate and update departmental policies and procedures
Serve as the subject matter expert on the assigned function product to ensure operational performance
Ability to travel
Performs other duties as assigned.
Complies with all policies and standards."
EEO:
Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.
==================
" Perform various analysis and interpretation to link business needs and objectives for assigned function.
" Support business initiatives through requirements elicitation and documentation
" Identify implementation barriers and support resources conducting user acceptance testing of various systems
" Identify and analyze user requirements, procedures, and problems to improve existing processes
" Perform detailed analysis on behalf of our business partners, recommend potential business solutions and ensure successful implementations
" Coordinate with various business units and departments during cross-functional projects
" Develop, share, and incorporate organizational best practices into business applications
" Diagnose problems and identify opportunities for process redesign and improvement
" Serve as the subject matter expert in the requirements space to support project success.
" Performs other duties as assigned.
" Complies with all policies and standards.
|
| Story Behind the Need |
This request is part of a broader staffing initiative supporting the ABS Migration Program, a large-scale enterprise transformation effort to migrate core ABS processing capabilities to the TriZetto Facets platform prior to ABS reaching end-of-service (Q4 2027). The program impacts multiple lines of business, operational areas, integrations, data conversions, and business processes across California and Oregon.
The Business Analysis team serves as the bridge between business stakeholders, technology teams, and the implementation vendor, ensuring business requirements are captured, validated, traced, and successfully implemented. These resources will support requirements gathering, process analysis, impact assessments, data migration activities, testing support, and operational readiness across multiple business domains.
The team operates in a highly collaborative, fast-paced environment, partnering with Health Plans, Operations, IT, Product, Finance, Compliance, Member and Provider Services, and external vendor partners. The program follows a domain-based delivery model, requiring Client to work across cross-functional teams while helping manage dependencies, risks, decisions, and business readiness activities.
This hiring request aligns with the program's resource strategy, which identified the need for additional Business Analyst support to manage the volume and complexity of requirements and ensure successful delivery throughout the migration lifecycle.
| |
| Typical Day in the Role |
Day-to-Day Responsibilities- Oversight and understanding of vendor requirements
- Business requirement elicitation and documentation for work processes surrounding the ABS migration that will not be captured by Cognizant (vendor doing core migration activities)
- Facilitate and participate in requirements workshops with business and vendor partners.
- Document and analyze current-state and future-state business processes outside of the efforts Cognizant (vendor) is focusing on
- Identify business, operational, and system impacts.
- Review and validate requirements, decisions, dependencies, and risks.
- Support data migration planning, integration discussions, testing, and operational readiness activities.
- Partner closely with business stakeholders, project managers, IT teams, and external vendors to drive alignment and delivery
Performance Expectations / Metrics- Deliver high-quality, complete requirements documentation.
- Maintain clear requirements traceability and dependency management.
- Facilitate stakeholder alignment and timely decision-making.
- Proactively identify risks, gaps, and impacts.
- Successfully support testing, readiness, and implementation activities while managing multiple workstreams simultaneously
What Makes This Role Unique- Opportunity to support one of Centene's largest enterprise transformation programs.
- High visibility with business and technology leadership.
- Exposure to enterprise-scale data migration, integrations, operational transformation, and healthcare platform modernization.
- Ability to influence future-state business processes and operational models while working across a diverse set of stakeholders and business domains.
| |
| Candidate Requirements |
| Required: Bachelor s degree in related field or equivalent experience | Preferred: Business analysis experience | |
| Required: NA | Preferred: | |
Years of experience required: 4-6 years of business process or data analysis experience, preferably in healthcare
Disqualifiers: N/A
Additional qualities to look for:
" Experience leading business analysis and requirements for enterprise or highly regulated environments
" Strong facilitation skills with senior stakeholders and cross functional teams
" Ability to translate complex business problems into clear, actionable requirements
" Experience working within structured project lifecycles and governance models
" Demonstrated strength in prioritization, scope management, and ambiguity navigation
" Proven ability to influence without authority and partner effectively across teams
" Background in the healthcare industry would be beneficial |
| 1 | Requirements elicitation and documentation: ability to lead workshops and document the business needs | |
| 2 | Experience analyzing complex business processes across multiple operational areas | |
| 3 | Large scale system migration experience | |
| Candidate Review & Selection |
| Projected Manager Candidate Review Date: | 1-2 days post shortlisting | |