Business Analyst ProfessionalBookmark This
Act as a business analyst for eligibility implementations, re-implementations, and member ID conversions.
Under the direction of a project manager, facilitate the eligibility interface requirements analysis, documentation, testing, and system set up functions for new client implementations and client support projects.
Core functions include: implementing participant, group, provider, and indemnity client data interfaces; participating in analysis and design specifications for system enhancements related to client requirements; and testing of client data loads and system setup. Additionally, this individual will participate in client related data issues and problem resolution.
The 5 or 6 major task areas required of the incumbents to successfully perform in this job. This list should address at least 80 percent of the job's content.
Weight: (%) (total = 100%)
1. Under the direction of a project manager, works with external clients to define requirements for implementations, re-implementations, and member ID conversions, ensuring that the eligibility business needs are being met. Documents those requirements following the standard eligibility methodology. Analyze the system data mapping requirements of the clients' proprietary layout or the HIPAA 834-standard layout to the client's proprietary layout. 40%
2. Under the direction of a project manager, reviews eligibility system capabilities, workflow, and scheduling limitations to determine if requested business requirements or program change is possible within existing system. Negotiates with external clients to minimize the impacts to the client's system and processes. Studies existing client data processing and system set up to evaluate effectiveness and proposes modifications set up or systems to improve productivity or workflow as required. 20%
3. Under the direction of a project manager, documents client-specific test plans, works with client to generate the appropriate test files, and executes the client load testing on our eligibility system. 20%
4. Under the direction of a project manager, performs analysis of eligibility data and system issues, proposes recommendations for solutions regarding client data, system setup, and system functionality and obtains appropriate approvals, and manages through resolution. 10%
5. Works on special projects and initiatives as assigned. 10%