Business Analyst II, Claims, Excel
Centene Corporation
Senior Business Analyst – Care and Case Management
Gainwell Technologies
full-time
Posted on:
Location: Colorado • 🇺🇸 United States
Visit company websiteSalary
💰 $69,400 - $99,200 per year
Job Level
Senior
Tech Stack
SQL
About the role
- Contribute to designing and delivering solutions for Care & Case Management to improve member health outcomes
- Understand new Case and Care Management policies and generate business/data specifications to meet evidence requirements
- Apply CMS policy and regulatory knowledge when developing functional requirements
- Facilitate design sessions with customers, developers, and third-party vendors and generate design specification documents
- Enter approved requirements into ALM and maintain RTM; run ALM RTM reports to verify requirements
- Partner with development and test teams; support generation of user stories, test scenarios, and test data for system integration and end-to-end testing
- Develop test scenarios and data for Model Office and End-to-End Testing
- Support UAT and participate in end-to-end functional testing
- Support development of user training collateral and participate in end-user training
- Communicate project metrics/status, identify and document risks, and assist with operational readiness and change management
- Serve as SME for end-to-end work and data flow for the Care and Case Management application ecosystem
- Build strong working relationships with Gainwell team and client stakeholders
Requirements
- 5+ years of experience as a Business Analyst, including 3+ years in Medicaid programs and 3+ years in multi-vendor environments
- Proven ability to interpret high-level requirements and translate into detailed functional and technical specifications
- Strong client communication and presentation skills
- Leadership experience mentoring and guiding junior colleagues
- Hands-on experience with requirements traceability management (RTM), test scenario creation, and test case execution
- Advanced proficiency in Excel (including pivot tables); working knowledge of Word, PowerPoint, ALM, and AI tools
- Strong technical writing skills
- Knowledge of CMS policies and regulatory requirements associated with Case and Care Management
- Preferred: 2+ years supporting Healthcare Case Management
- Preferred: Experience writing/executing SQL queries
- Preferred: Proficiency in Visio
