[Hiring] Business System Analyst @Blackbuck Insights

Role Description

We are seeking a Healthcare Business Systems Analyst to support the design, analysis, and delivery of integration and member-intelligence solutions for healthcare payer programs. This role sits at the intersection of business analysis, enterprise integration, cloud platforms, and health-plan operations—helping connect eligibility, claims, clinical, pharmacy, and social-need data so the organization can see and act on the whole member.

Essential Duties

• Requirements Analysis and Documentation: Partner with product, clinical, analytics, operations, IT, and vendor stakeholders to elicit, analyze, and document business requirements, functional specifications, user stories, process flows, data mapping needs, and acceptance criteria.
• Member 360 and Whole-Person Insights: Support initiatives that stand up and mature Member 360, member segmentation, and Whole Person Index capabilities used by care management, quality, population health, and value-based teams.
• Healthcare Payer Process Analysis: Analyze current-state payer landscapes across eligibility, enrollment, claims, clinical, pharmacy, provider, care management, and member engagement domains to identify gaps, dependencies, and improvement opportunities.
• Integration and Data Flow Support: Work with technical teams to translate business workflows into integration requirements across on-premises and cloud-native environments, supporting reliable and compliant data exchange between systems.
• Testing and Validation: Support SIT, UAT, defect triage, production validation, and issue resolution by developing test scenarios, reviewing outcomes, validating business rules, and confirming that member profiles and operational workflows meet stakeholder needs.
• Regulatory and Compliance Alignment: Ensure requirements, data flows, and solution designs account for HIPAA, payer data-handling requirements, and public-sector constraints where applicable.
• Stakeholder Communication: Serve as a bridge between business stakeholders and technical delivery teams, communicating priorities, risks, dependencies, decisions, and next steps clearly and professionally.

Qualifications

• Education and Experience: Bachelor’s degree in computer science, engineering, health informatics, business, or another relevant discipline, and a minimum of 4 years of related experience. Five (5) years of directly relevant experience may be substituted for a degree.
• Healthcare Business Systems Analysis: Minimum of 3 years of experience analyzing, documenting, and supporting complex healthcare payer business systems, workflows, integrations, or multi-workstream programs.
• Payer Domain Knowledge: Experience supporting payer operations such as eligibility/enrollment, claims, care management, provider data, member engagement, population health, or quality programs.
• Requirements and Process Documentation: Demonstrated ability to create business requirements, functional requirements, user stories, workflow diagrams, data mapping documentation, test scenarios, and acceptance criteria.
• Integration Awareness: Working knowledge of integration concepts, system interfaces, data exchange patterns, and technologies commonly used in payer environments, including Java/JEE, Spring, APIs, cloud services, or equivalent integration platforms.
• Cloud and Data Platform Exposure: Hands-on or project experience with AWS, Azure, Google Cloud, or equivalent cloud services used to host or integrate health plan applications, data platforms, or member analytics environments.
• Compliance Knowledge: Working knowledge of HIPAA and payer data-handling requirements, with the ability to incorporate compliance considerations into requirements, testing, and delivery activities.
• Communication Skills: Strong analytical, written, verbal, facilitation, and stakeholder-management skills, with the ability to translate business needs into clear delivery-ready requirements.

Preferred Qualifications

• Demonstrable experience supporting or delivering Member 360 programs that combine eligibility, claims, clinical, pharmacy, utilization, and engagement data into a unified operational and analytical view.
• Hands-on work with member segmentation and population stratification, including risk cohorts, condition cohorts, utilization tiers, and social-need cohorts used to drive care management, quality, and value-based programs.
• Experience building, supporting, or operationalizing a Whole Person Index or comparable composite member-risk model that blends clinical, behavioral, and social determinants of health into actionable scores.
• Experience with Medicaid, Medicare Advantage, or commercial health plan platforms, including core administration systems, MMIS-adjacent systems, care-management platforms, or payer data warehouses.
• Experience with ServiceNow implementations supporting health plan IT operations, intake, workflow management, or care and operations processes.
• Familiarity with FedRAMP authorization and cloud solution delivery for state Medicaid agencies, CMS-aligned programs, or public-sector payer environments.
• Current AWS, Azure, or Google Cloud certification.
• Experience with healthcare interoperability patterns, including FHIR, HL7, X12/EDI 834/837, and identity resolution across member, provider, and community-partner data sources.