* Hi*
*I have an urgent requirement with one of my clients, details given below. If you find yourself suitable for the position, please send me your latest updated resume along with contact details. Please include your employer details as well and reply to my official id [email protected] <[email protected]> JOB TITLE: Sr. Business Analyst (Healthcare) Location: OR-Oregon/Lake Oswego Duration: 12 Months M.O.I Telephonic + Skype* *End client:-kaiser permanente* *Only required PST Consultant which having good experience in Medicare or Medicaid, EDI X12 ANSI* *Job Summary* The *Senior Business Analyst* acts as the primary liaison between IT and the operational departments within the organization. This position functions in a trusted advisor role, by providing subject matter expertise to the clients in whom it serves, through analysis activities and the development of business and functional requirements for initiatives of all sizes. The Senior Business Analyst serves in interface development management and participates on project teams to assist in a timely delivery of all IT projects. This role also serves as a mentor to team members. *Financials, Operations, Billing and Receivables* – Additional qualifications include: - Experience with claims processing systems from other industries will be considered - Knowledge of customer, product and pricing concepts required - *Knowledge of Medicare and Medicaid processing a plus* - Health Plan entities include individual consumers, state, the federal government, and other ancillary parties - Ability to query and map data - *Epic experience is preferred* including batch processing - *Knowledge of EDI 835, 837 and 820 characters is a plus* - Preferred location of work is in Portland, Oregon or California *Enrollment Processing* – Additional qualifications include: - Experience with group, customer, and benefit product concepts - Experience with enrollment rule requirements and differences by product line - Ability to work with file processing as well as query and map data - *Knowledge of EDI X12 ANSI* formats a plus - Knowledge of *claims system outputs* that are by-EOB, Letters, ID cards, etc. *Member/Provider Services* – Additional qualifications include: - Previous experience with the provider and customer service functions, which includes applications and processes used to service and support interactions with consumers/providers including - Experience with group, customer, and product and customer service applications - Experience with servicing of health care providers - Ability to query and map data and define file specifications for third-party vendor relationships *Medicare Services*– Additional qualifications include: - Knowledge on Medicare *Job Requirements: Responsibilities* - Analyzing business domain and development of workflows and requirements for proposed solutions in support of day-to-day and program initiatives - Subject matter expertize and ownership of assigned operational area - Defining problem/need and primary objectives for new projects, identifying and validating key requirements. - Analyze, define and document requirements for data, workflow, logical processes, hardware and operating system environments, interfaces with other systems, internal and external checks and controls, and outputs. - Compile comprehensive designs that explain expected changes and accounting for interdependency of applications - Leading of requirements elicitation sessions - Conducting requirements reviews to obtain sign-off from project/operational stakeholders. - Documenting and appropriately capturing functional specifications used for software interface design and development. - Preparation and maintenance of project-related requirements artifacts – Business & Functional Requirements Document, Physical Solution Design Documents, Traceability Matrix, Use Case Diagrams, Unit Test Case, etc. - Managing project tasks assigned within scope, quality and timeframe allocated with PM/departmental supervision. - Identifying and recording of risks, issues, dependencies and assumptions in accordance with project standards. - Interaction with all areas of Information Technology as well as software vendors - End-to-end ownership of assigned initiatives – requirements through implementation - Problem analysis in batch and online environments with the ability to interrogate error codes - Analyzing and querying data, knowledge of data models - Testing, including the creation of test scenarios, test data and knowledge of outcomes - Interaction and engagement with leadership and staff from assigned and supporting operational and production support areas - Mentoring of clients and peers *Qualifications* - BA/BS - Bachelor’s Degree or equivalent required. Degree in Computer Science or Computer Programming a plus. - *Minimum 5-8 years previous experience as a Business/Systems Analyst * - *Health Care Industry experience - understanding of Medicaid and Medicare programs.* - Proficiency with Microsoft tools including Excel, Word, Visio, PowerPoint, and Access - Proficiency with SQL (querying, analyzing and mapping data) - Demonstrated ability to lead and elicit business needs and requirements from a diverse set of stakeholders and successfully document and communicate requirements to the stakeholders, developers and testers. - Demonstrated ability to construct or modify use case diagrams and process models. - Demonstrated ability to create test scenarios - Experienced in full software development life cycle - Understanding of the concept of online and batch environments - Ability to work multiple, time-critical tasks. - Demonstrated ability to analyze and solve problems - Excellent oral and written communications skills with the ability to interact with all levels of leadership - Excellent interpersonal skills - *Experience of EDI 835, 837 and 820 transaction* - *Demonstrated knowledge of Epic environment, batch environment and data model experience* Thanks & Regards, *Amit Sharma* *Technical Resource Specialist* *RG Talent Inc* *39120 Argonaut way* * Suite # 157, Fremont CA 94538* Phone : 510-443-0758 Ext 115 Email : [email protected] URL : www.rgtalent.com In my absence please contact *Javed *at following address [email protected] <[email protected]> *Disclaimer: Under Bill s. 1618 Title III passed by the 105th U.S. Congress this mail cannot be considered spam as long as we include a way to be removed from our mailing list. 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