Healthcare Business Analyst

3 weeks ago


New England, United States Saxon Global Full time
HealthCare Business Analysst

Location: Remote - needs to come onsite once per quarter. Needs to be in New England

Interview Process: 1-2 rounds

Looking for Business Analys's with healthcare knowledge, understand the directory, and worked on mandates.
  • Open to mandate exp from any state but ultimate plus is mandates from MA
  • Any experience working with third party vendors
    • Collection vendor = CAQH
    • Provider Directory vendor = Zelis/Saphire Digital
      • 22 Blue plans use them as a vendor
      • They would probably know the CMS mandates
    • They will present back and forth - not one side vs. the other
    • Balance of understanding systems and business
      • CAQH will send files to BCBSMA, they ingest into their system and then they store them (turned into file)
        • Some process pulls all the files/provider data which get organized and displayed
      • Understand apps, data and flow of data
    • Some of the regulations are process related, not technical
  • Project Manager will be similar profile/requirements but product focused.
    • They are not totally sure how Agile this will be run
      • Tough to be Agile with the vendor balance
    • Big benefit to be able to run in both and flexible to delivery requirements


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