Business Analyst - Health Plan Systems (Remote)

About the Role

We're looking for a Business Analyst - Health Plan Systems to join Harbor Health's transformative team. This remote position offers the opportunity to contribute to a member-centered experience that integrates comprehensive care with modern payment models. You'll be part of a dynamic work environment where your contributions are recognized, and you'll help improve healthcare delivery.

What You'll Do

• Drive business requirements, process improvements, and system enhancements to support health plan growth and improvement initiatives.
• Lead operational performance improvement initiatives.
• Develop and approve business requirement documents.
• Create and validate test cases during User Acceptance Testing (UAT).
• Serve as a subject matter expert in enrollment and billing systems.
• Engage with IT and vendors to resolve issues effectively.
• Perform root cause analysis for enrollment processes.
• Collaborate to implement system changes that enhance member satisfaction.
• Analyze data to evaluate initiative outcomes.
• Monitor vendor compliance and performance.
• Develop business specifications for technical projects.

Requirements

• 3+ years of experience in member enrollment and data analysis.
• Expert knowledge of healthcare billing data.
• Strong SQL skills are essential.
• Excellent communication skills to facilitate collaboration.
• Experience in developing Requests for Information (RFIs) for vendor selection.
• Knowledge of CMS requirements.
• 2+ years of experience in developing test cases and UAT.
• Significant knowledge of Individual and Family Plans (IFP) and Affordable Care Act (ACA) enrollment systems.
• Understanding of HIPAA 834 transactions.

Nice to Have

• Experience with data visualization tools.
• Familiarity with Agile methodologies.
• Certifications in business analysis or healthcare.

What We Offer

• Opportunity for career development in a collaborative work environment.
• Be part of an impactful organization in the healthcare sector.
• Competitive salary and benefits package.
• Professional growth opportunities.
• Transparent and unique company culture that values innovation.