Business System Analyst

Consultant II

 

Who We Are:

UST HealthProof is a trusted partner for health plans, offering an integrated ecosystem for health plan operations. Our BPaaS solutions manage complex admin tasks, allowing our customers to prioritize members’ well-being. With our commitment to simplicity, honesty, and leadership, we navigate challenges with our customers to achieve affordable health care for all.

We have a strong global presence and a dedicated workforce of over 4000 people spread across the world.

Our brand is built on the strong foundation of simplicity, integrity, people-centricity, and leadership. We stay inspired in our goal to unburden healthcare and ensure it reaches all, equitably and effectively.

 

You Are:

The Business System Analyst (BSA) will help in capturing the business requirements to run the health plan customer’s Core admin business functions while implementing UST HealthProof’s core-admin ecosystem. The BSA will work with the Health Plan Customers, third party vendors/partners, Internal product teams, solution architects and product owners to define the business rules and processes required for implementation.

 

 

The Opportunity:

·       Preferred bilingual - Spanish and English speaking

·       Leading business requirement conversations with customer and internal teams.

·       Managing the end-to-end requirements involving all the stakeholders.

·       Responsible for developing business and functional requirements for Claims, Enrollment, Provider, Authorization, Payment systems. 

·       Create solutions for current business processes using UST HealthProof’s core-admin ecosystem.

·       Negotiate with client to develop processes that are current and applicable to the situation.

·       Collaborate with business users, management, IT, and offshore staff to ensure the finish product meets project objectives and client expectations by applying ‘Agile like’ project methodology.

·       Instrumental in analyzing the healthcare business requirements and translating them to functional and technical requirements. 

·       Identify opportunities for automation, performance improvements, reusability.

·       Develop high level workflow diagrams and system context diagrams.

·       Document the understanding of the process flow using swim lanes diagrams.

·       Produce the Requirements plan that aligns with the overall Project Implementation plan.

·       Dictate the risks and dependencies in the timely manner with the Customer to complete the requirement gathering to meet up with the project plan dates.

·       Must work with Offshore Business Analysts to elaborate user stories.

·       Conduct Requirement walk through with the customer and internal/external stakeholders.

·       Collaborate with the development team & QA team to ensure the finish product meets project objectives and client expectations.

·       Contribute towards sprint planning, retrospective, go-live/no go-live evaluation meetings.

·       Conduct Demo of MVPs for the customer.

 

This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.

 

What You Need:

·       Knowledgeable in Healthcare insurance domain (Medicare, Medicare Advantage, Medicaid, ACA or Commercial).

·       Exposure to healthcare eco-systems from partners like HealthEdge, TriZetto , NASCO, Advantasure or Change Healthcare.

·       Experience with mapping of EDI healthcare transactions (837, 834, 835,270/271, 276/277, 278)

·       Bachelor’s degree or higher in business or technical field, Eight plus years of relevant work experience in business analysis.

·       Awareness to Agile tools and scrum methodologies.

·       Communication skills with peers, customers, and partners including the ability to convey information effectively.

·       Experience in analysing the business requirements and translating/mapping them to technical requirements in EDI technology by analysing implementation/companion/TR3 guides.

·       Experience documenting requirements or user stories and communicating the requirements to technical teams, partners/vendors or product teams Experience working in an onshore/offshore model is a must.

·       Experience working HealthEdge applications like HealthRules Payor or GuidingCare is a plus.

·       Understanding of SQL, XSDs is a plus.

 

Compensation can differ depending on factors including but not limited to the specific office location, role, skill set, education, and level of experience. UST HealthProof provides a reasonable range of compensation for roles that may be hired in various U.S. markets as set forth below.

Role Location: Remote

Compensation Range:   $109,000-$130,000

 

A successful employee in this role may be eligible for incentive payments based on company and individual performance.

 

Benefits

Full-time, regular employees accrue up to 16 days of paid vacation per year, receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year), 10 paid holidays, and are eligible for paid bereavement leave. They are eligible to participate in the Company’s 401(k) Retirement Plan with employer matching. They and their dependents residing in the US are eligible for medical, dental, and vision insurance, as well as the following Company-paid benefits: basic life insurance, accidental death and disability insurance, and short- and long-term disability benefits. Regular employees may purchase additional voluntary short-term disability benefits, and participate in a Health Savings Account (HSA) as well as a Flexible Spending Account (FSA) for healthcare, dependent child care, and/or commuting expenses. Certain regular employees may have the potential for quarterly incentive-based bonuses and or commissions depending on role. Benefits offerings vary in Puerto Rico.

Part-time employees receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year) and are eligible to participate in the Company’s 401(k) Retirement Plan with employer matching.

Full-time temporary employees receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year) and are eligible to participate in the Company’s 401(k) program with employer matching. They and their dependents residing in the US are eligible for medical, dental, and vision insurance.

Part-time temporary employees receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year).

All US employees who work in a state or locality with more generous paid sick leave benefits than specified here will receive the benefit of those sick leave laws.

What We Believe

At UST HealthProof, we envision a bold future for American healthcare. Our values are the bedrock beliefs our organization holds dear. They not only define what our brand stands for but also serve as a compass guiding every action and decision.

Guiding Principles

These principles illuminate the path of ‘how’ we operate. They detail actions and behaviors we much embody to honor our values and achieve our goals.

·       Simplicity

Simplifying complexity underlines everything we do—this approach is what makes us unique. We come with an open mind and straightforward approach, cutting our way to the core with measurable and actionable insights.

·       Integrity

Integrity is our currency to build relationships. We believe in being open and honest. It is only natural when we have nothing to hide. It demonstrates that we are here to do the right thing, no matter who is watching.

·       People-Centricity

Everything that we do reflects our deep bonds with peers and customers. These aren't mere transactions, but transformational ties. They shape our culture and decisions, affirming that our true value lies in the lives we touch and impact.

·       Leadership

Taking ownership is about taking initiative, being in-charge and driving things to completion. It’s a brave choice to ‘own’ all aspects of our work, ensuring we take full responsibility for everything we handle.

Mission

A future possible only when health plans are free from administrative burdens so they can truly focus on what matters more – their members’ well-being.

Equal Employment Opportunity Statement

UST HealthProof is an Equal Opportunity Employer.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other applicable characteristics protected by law. We will consider qualified applicants with arrest or conviction records in accordance with state and local laws and “fair chance” ordinances.

UST HealthProof reserves the right to periodically redefine your roles and responsibilities based on the requirements of the organization and/or your performance.

 

 

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