We exist for workers and their employers - who are the backbone of our economy. That is where Centivo comes in - our mission is to bring affordable, high-quality healthcare to the millions who struggle to pay their healthcare bills.

BUSINESS ANALYSIS & REQUIREMENTS GATHERING:

• Work closely with business users (Claims, PDM, IT, etc.) to gather and document system requirements, and translate them into actionable, functional specifications.
• Conduct gap analyses to identify system inefficiencies and collaborate with the team to implement solutions that improve workflows and business processes.
• Provide subject matter expertise on system configuration, ensuring new features and changes meet business needs.

EDUCATION:

• Bachelor’s degree in a relevant field such as Healthcare, Business, Computer Science, or Mathematics.

EXPERIENCE:

• 5+ years of experience working with core platform systems in a health plan, TPA, or healthcare-related setting.
• Experience with Health Rules Payer preferred.
• Experience with Provider Data profiles and network configuration.
• Hands-on experience with health plan building, benefits configuration, and system administration in core platform systems.
• Familiarity with healthcare operations, including claims adjudication, enrollment, and provider management processes.

SKILLS & COMPETENCIES:

• Advanced skills in data analysis tools like Excel, PowerPoint, SQL, and other related software applications
• Strong analytical and problem-solving skills with the ability to translate business needs into system configurations and solutions.
• Understanding of plan building, benefits configuration, and related system settings.
• Experience with system integrations and interfacing with third-party vendors.
• Knowledge of healthcare regulations and standards, including HIPAA, CMS, and ACA.
• Proficient in project management and documentation tools (e.g., JIRA, Confluence, Microsoft Project).
• Excellent communication skills, both written and verbal, with the ability to engage with both technical and non-technical stakeholders.
• Detail-oriented with a strong focus on system optimization, data integrity, and process improvement.
• Ability to manage multiple priorities and deadlines in a fast-paced environment.

PREFERRED QUALIFICATIONS:

• Familiarity with business intelligence tools (e.g., Tableau, Power BI) for reporting and analysis.
• Certification in Business Analysis (CBAP, PMI-PBA) or IT systems management is a plus.

WHO WE ARE:

Centivo is an innovative health plan for self-funded employers on a mission to bring affordable, high-quality healthcare to the millions who struggle to pay their healthcare bills. Anchored around a primary care based ACO model, Centivo saves employers 15 to 30 percent compared to traditional insurance carriers. Employees also realize significant savings through our free primary care (including virtual), predictable copay and no-deductible benefit plan design. Centivo works with employers ranging in size from 51 employees to Fortune 500 companies. For more information, visit centivo.com.
Headquartered in Buffalo, NY with offices in New York City and Buffalo, Centivo is backed by leading healthcare and technology investors, including a recent round of investment from Morgan Health, a business unit of JPMorgan Chase & Co.
Compensation Range: $105K - $115