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Sr. Enterprise Business Analyst – Healthcare Insurance Payer Side

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Direct Hire

$95,000 - $150,000 / yr

Our client is seeking a passionate, results-oriented Senior Enterprise Business Analyst who can collaborate effectively with internal and external stakeholders to analyze, define and manage requirements to launch new product & services.  The ideal candidate will have worked in-depth for top payers across one or more domains (Enrollment & Benefit Administration, Claims processing & Reimbursements, Member & Provider Portals/Service, Clinical & Care management, Funding & Billing, Reporting). This person must possess a blend of business and technical savvy; strong communication skills to collaborate across internal and external stakeholders.


Primary Responsibilities:

  • Healthcare Operations experience is a plus only, must have TPA/Payer besides this
  • PBM experience is a plus only, must have TPA/Payer besides this
  • You will work with business and solution owners to define and document requirements for the assigned products and services, as well as write user stories, acceptance criteria, feature description decks, process flows, manage traceability and UAT.
  • You will maintain a solid knowledge base of the functional capabilities of the various areas and products within the assigned product portfolio.
  • You will use agile methods to analyze, define and document requirements and manage traceability. You will work with stakeholders and product teams to drive consensus on scope, design and implementation decisions.
  • Provide analysis and impact to user and business for changes to current functionalities and applies problem solving skills to meet business needs.
  • Develop and integrate requirement management to the delivery approach and schedule; you will also be responsible for product quality, project timeliness, and customer satisfaction.
  • Participate in the presentation of information to customer and internal business and or IT teams.
  • Creates business / product / third party vendor specifications for product integration and implementation.

 High Level Requirements:

  • Within the last 5 years must have had Payer Implementation experience with large healthcare clients in a commercial/TPA setting
  • Client facing skills on large programs
  • 6+ Years of Payer experience required with the majority of this as a Sr. BA


  • Client Facing skills, ability to lead requirements sessions in the healthcare payer industry.
  • Minimum 6-7 years of experience as a business analyst in healthcare payer industry (Commerical/TPA).
  • Expertise and experience in preparing High Level requirements, Use Cases, Business Requirement Documents, Functional specifications, Test strategy & cases and Traceability matrix.
  • Proven ability to map business process and workflows, conducting gap analysis and documenting requirements, ensuring requirements are developed and tested.
  • Excellent verbal/written communication skills; comfortable leading business and technology teams within the organization to translate business issues & requirements into technical solutions.
  • Healthcare Insurance Payer in one of more of the following areas: Claims Administration, Enrollment & Eligibility, Benefit Administration, Contribution Accounting, Billing & Payment, Member, Provider and Employer facing portal/service.
  • Ability to analyze problems and resolve issues through resolution quickly and methodically.
  • Proficient with Word, Excel, and PowerPoint, Visio.
  • Knowledge of BA/MS Office 365 tools, JIRA, MS Project
  • Self-motivated and detail oriented.
  • Flexibility to adapt to change and willing to learn and develop new skill sets as applicable.
  • Bachelor’s degree or equivalent experience. 
  • BA Certifications


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