Business Analyst for Implementation Solutions

3 weeks ago


Annapolis, Maryland, United States Evolent Health Full time
Company Overview
Evolent Health partners with health plans and providers to achieve better outcomes for people with complex and costly health conditions. We seek to connect the pieces of a fragmented healthcare system and ensure people receive the same level of care and compassion as we would want for our loved ones.

We believe that people do their best work when supported to live their best lives, and when they feel welcome to bring their whole selves to work. This is why diversity and inclusion are core to our business.

Estimated Salary Range: $100,000 - $125,000

Job Description
This individual will spearhead requirements management for implementation projects across our client and Evolent organizations. By driving Evolent's mission, they will play a pivotal role in delivering our value-based strategy with partners and contribute to dynamic initiatives that propel the growth of our department and team.

Responsibilities
- Clearly define requirements, process flows, use cases, and acceptance criteria for CMS and Commercial programs.
- Facilitate communication between business/IT teams, developers, and external stakeholders.
- Identify, document, and analyze discrepancies and anomalies within automated data reconciliation and disputed data.
- Document business and system requirements standards when new system enhancements or engineering changes are required. Maintain standard templates and support ongoing maintenance.
- Develop a deep understanding of end user outputs, platform development & configuration, multisystem functional requirements, business rules, and leverage that knowledge to improve processes, recommend solutions, enhance team performance, and drive progression of client objectives.
- Prioritize mitigation efforts for action items, risks, and issues.
- Analyze and address process and software gaps.

Requirements
- Bachelor's degree or equivalent experience.
- Able to own and write the Business Requirement Document (BRD) independently for any given domain function with minimal assistance.
- 5-8+ years of IT and/or business experience in an HMO/PPO Claims, Medicaid, Medicare, and/or managed care healthcare environment.
- Knowledge of the Affordable Care Act, HMO, and managed care principles including Medicaid and Medicare regulation.
- Extensive experience with the System Design Life Cycle (SDLC).
- Experience with EDI X12 structure and syntax rules; chiefly with 834 files.
- Superior root cause analysis skills, including corrective action planning and ability to provide documentation to support analysis.

Benefits
We offer comprehensive benefits to qualifying employees, including health insurance benefits. All compensation determinations are based on the skills and experience required for the position and commensurate with experience of selected individuals, which may vary above and below the stated amounts.

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