QUALIFICATIONS:

• 7+ years as a Business Analyst/Product Specialist in healthcare payer or health plan administration.
• Experience in enrollment, benefits, claims, billing, vendor integration, portals, or contribution accounting.
• Strong analytical/problem-solving skills and ability to resolve issues quickly.
• Proficiency in MS Office, Visio, JIRA, MS Project.
• Excellent communication and stakeholder management skills.
• Bachelor’s degree or equivalent (BA certification/PMP a plus).
• Preferred: Blue Card program experience.
  Job Type: Full-time
  Work Location: Remot

ROLE OVERVIEW:

We are seeking a Senior Business Analyst/Product Specialist with strong expertise in the healthcare payer domain (TPA, benefits & claims administration, vendor integration, portals, networks). This role requires a blend of business and technical skills, with the ability to collaborate across business and IT teams to deliver scalable solutions.

KEY RESPONSIBILITIES:

• Partner with stakeholders (Eligibility, Benefits, Finance, IT, Networks) to gather and define requirements.
• Document BRDs, user stories, acceptance criteria, workflows, and manage UAT.
• Conduct gap analysis, process mapping, and recommend enhancements.
• Support product integration, vendor specifications, and implementation.
• Drive stakeholder consensus on scope, design, and implementation decisions.