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Senior Business Analyst

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Senior Business Analyst

Experience: 5 – 8 Years
 
Location: Remote
 
Job Description:
  • Works with stakeholders to discover, clarify, and document current and future data needs.
  • Performs mapping of claims, insurance, and supplemental clinical data into a normalized data model.
  • Serves as a subject matter expert on the Population Health and Insurance data domains such as Medical Claims, Pharmacy Claims, Dental Claims, Eligibility, Member PCP, Provider, Revenue.
  • Builds data concepts to support Population Health and Insurance use cases.
  • Serves as a key resource for an assigned customer area to understand and explain business and technical issues and to provide viable technology solutions.
  • Supports clinical quality initiatives such as patient rosters and HEDIS.
  • Supports value-based care KPIs, Health Plan operations, regulatory requirements, Medicaid, Medicare, and commercial populations.
  • Supports Interoperability, Clinical Quality, Care Management, Analytics and Reporting, and Risk Management initiatives.
  • Acts as a quality consultant and subject matter expert, performing testing and validation of the mapping of data elements to standards.
  • Performs discovery and can efficiently analyze large data sets identifying gaps.
  • Collaborates with technical resources to perform root cause analysis and complete remediation of data quality issues.
  • Works with customers to clarify and plan for their current and future technology needs.
  • Determines and maps existing business processes/functions and recommends changes required to fit a tightly integrated system.
  • Designs and implements projects requiring systems integration, small teams, and multiple technical platforms.
  • Conducts Return on Investment (ROI) and other financial analysis to support project funding/prioritization.
  • Collaborates on driving improvement activities to achieve department and organizational goals.
  • Coordinates with functional team to assure consistency and optimization of overall work product.
  • Assumes a proactive role in driving improvement activities to achieve department and organizational goals to deliver value.
  • Maintains current knowledge of industry and business process trends and applies that knowledge to existing business processes.
  • Provides subject-matter expertise of Health Ministry processes, policies, and requirements in support of functional area process design, testing, and implementation.
  • Identifies opportunities for process improvement and makes recommendations that lead to improvements.
  • Monitors task assignments to ensure they are performed on schedule, within intended scope, and to a defined level of quality.
  • Escalates process and project issues that cannot be resolved.
  • Prior experience working as a Population Health, Insurance, or Claims analyst in the Healthcare system.
  • Must have a working knowledge of relational databases/database structures, SQL experience desired.
  • Must have a strong understanding of data collected and used in Rosters, Claims Processing, Eligibility, Health Insurance Exchanges, and Care Management Systems.
  • Knowledge and experience with healthcare claims and billing workflows and clinical information systems.
 
Send your resumes to: career@ceiyone.com; saranya.ravikumar@ceiyone.com
 
Note: Please include the role in the subject line of the email.
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Ceiyone offers a variety of roles in software development, project management, IT consulting, and emerging technology positions across departments.

We seek candidates with strong technical skills, problem-solving abilities, and passion for innovation in software and technology development.

Ceiyone values candidates with relevant technical qualifications, experience in software development, and expertise in emerging technologies or business processes.

We provide continuous learning opportunities, mentorship programs, and certifications to support your professional growth within software development and technology roles.

Yes, Ceiyone fosters internal promotions and career growth through training, mentorship, and access to new, challenging projects.

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