Senior Business Analyst (Healthcare)

Job Title: Senior Business Analyst (Healthcare)
Location: : Baltimore, MD (Remote)

ROLE: The Senior Business Analyst will have the responsibility to ensure that the business's need for changes to processes, policies and/or information systems are identified, understood, defined, documented and acted upon by eliciting, analyzing, documenting, validating, specifying and verifying the needs of business or user. The incumbent is accountable for the gathering and synthesizing of business requirements for moderate complexity software, systems, processes and/or services and translates them into specifications ensuring the business objectives are met. As the functional expert, the incumbent serves as a strategic conduit between the business area and the technical or software development team through which requirements flow.

Experience: 5 years progressive experience in business analysis, systems analysis, testing or other analytical experience

Preferred Qualifications
Demonstrated ability to deliver high quality, effective deliverables on-time and be a significant contributor to the development of cost-effective solutions.
Proven understanding of business analysis core competencies

Must Have Skills :
Prior experience with UM, CM, Clinical Operations
Prior configuration experience with Guiding Care (GC) Medical Management platform
Prior experience integrating with a DTR platform – MCG or InterQual
Prior experience with clinical test data creation
Familiarity with CMS-0057 F requirements
Excellent communication and presentation skills for a multi-party project environment
Excellent team building skills

Job Description :
Work closely with BSA and in house HS SME teams on Client and DTR providing GC SME
Validate and generate requirements from GC platform and Prior Auth perspectives
Work closely with DTR SMEs, HE GC team members
Work with the testing team in creating and validating sensible clinical test data