Business Analyst II – Policy Review

Centene Corporation

Business Analyst II performing analysis to link business needs in healthcare policy. Develops, implements, and maintains payment policies and ensures compliance and payment integrity.

Posted 7/20/2026full-timeRemote • Arizona, Florida, Missouri, Montana • 🇺🇸 United StatesJuniorMid-Level💰 $56,200 - $101,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in business process analysis within the healthcare sector, focusing on compliance, reimbursement methodologies, and claims adjudication. Proficient in data analysis and user acceptance testing to enhance operational efficiency and support business initiatives.

Highest-signal resume keywords

Business Process AnalysisHealthcare ComplianceReimbursement MethodologiesCoding Certification (CPC or Similar)Excel Skills (Pivot Tables, VLOOKUPs)

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Business Process AnalysisReimbursement MethodologiesClaims AdjudicationData AnalysisUser Acceptance TestingClaims Coding AppealsRevenue Cycle ManagementRegulatory Guidelines InterpretationPolicy DevelopmentOperational Reporting

Soft Skills

Problem SolvingCoordinationCommunication

Tools & Technologies

Managed Care Information SystemsExcel

Certifications & Qualifications

CPC Certification

Industry Keywords

HealthcareComplianceGovernancePayment PoliciesClaims ResearchBenefitsPricingContracting

About the role

Key responsibilities & impact

Perform various analysis and interpretation to link business needs and objectives for assigned function
Detailed reviews of both state specific and corporate Payment policies for Compliance and Governance ensuring policies are accurate and up to date with guidelines
Review, analyze, and interpret coding, reimbursement, and regulatory guidelines to ensure organizational compliance and payment integrity
Develop, implement, and maintain Payment Policies, reimbursement methodologies, and claims editing logic to support accurate claims adjudication
Monitor, report on, and track regulatory, coding, and policy updates, ensuring timely implementation and communication of changes across impacted stakeholders
Support business initiatives through data analysis, identification of implementation barriers and user acceptance testing of new systems
Identify and analyze user requirements, procedures, and problems to improve existing processes
Perform detailed analysis on assigned projects, recommend potential business solutions and assist with implementation
Identify ways to enhance performance management and operational reports related to new business implementation processes
Develop and incorporate organizational best practices into business applications
Lead problem solving and coordination efforts between various business units
Assist with formulating and updating departmental policies and procedures
Complies with all policies and standards.

Requirements

What you’ll need

Bachelor’s degree in related field or equivalent experience
2+ years of business process analysis, preferably healthcare
Knowledge of managed care information systems and experience in benefits, pricing, contracting or claims preferred
Knowledge of provider reimbursement methodologies preferred
Previous structured testing experience preferred
Coding certification such as a CPC or similar is preferred
Claims coding appeals or revenue cycle experience preferred
Claims research experience preferred
Excel skills with pivot tables and VLOOKUPs

Benefits

Comp & perks

competitive pay
health insurance
401K and stock purchase plans
tuition reimbursement
paid time off plus holidays
flexible approach to work with remote, hybrid, field or office work schedules