Business Analyst (MedTrac)
- Medical, Vision, Dental, Short- and Long-term insurance
- Paid Federal Holidays
- 16+ days of PTO
- Employer paid life insurance
- 401K with employer contribution
- Wellness program with reward incentives
- Employee recognition and reward programs
- Elicit, analyze, and document business and functional requirements for MedTrac features, integrations, and enhancements.
- Facilitate discovery workshops and stakeholder interviews with Clinical Operations, Utilization Management, Provider Relations, Revenue Cycle, and Compliance.
- Produce and maintain business analysis artifacts, including user stories, acceptance criteria, process maps (BPMN), data dictionaries, field-level mappings, and interface specifications.
- Translate client and regulatory requirements (e.g., CMS, HIPAA, NCQA) into system behavior with full traceability through UAT and release.
- Map current and future-state workflows; identify gaps, dependencies, and operational impacts.
- Support sprint planning, backlog refinement, and definition of done.
- Collaborate on integrations across portals, EDI/X12 (278, 275), claims, eligibility, and reporting/BI systems; document expected API and interface behaviors.
- Ensure end-to-end process continuity and data consistency with downstream systems, including claims, eligibility, and provider data integrations.
- Prepare UAT plans, test cases, and acceptance scripts; coordinate UAT execution, document results, and obtain sign-offs.
- Support post-release validation, production issue triage, and recommend system optimizations.
- Incorporate data quality, privacy, and compliance requirements into design and acceptance criteria to ensure audit readiness.
- Develop and maintain training materials, user guides, and reference documentation to support change management and adoption.
- Partner with external vendors, payer partners, and integration teams to ensure alignment and quality across systems.
- Balance functional requirements with compliance and audit-readiness considerations in all deliverables.
- Other duties as assigned.
- 4–7 years of experience as a Business Analyst or Systems Analyst in healthcare, managed care, or payer environments.
- Strong understanding of healthcare clinical workflows (home health, DME, infusion, orders/referrals, prior authorization, and provider portals).
- Proven ability to gather, document, and translate business requirements into technical specifications and testable outcomes.
- Experience managing Agile project documentation and sprint artifacts.
- Proficiency in writing user stories, acceptance criteria, process maps, and data rules.
- Experience leading workshops, interviews, and UAT.
- Agile backlog management with Jira or Azure DevOps.
- Tool proficiency: Visio/Lucidchart, SQL basics, and BI tools (Power BI).
- Excellent communication skills with clinical, operational, and technical audiences.
- Strong attention to detail, organization, and follow-through.
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