Business Analyst

• Analyze business requests to be solved with automated systems.
• Formulate and design automated systems scope and objectives based on both user needs and a good understanding of applicable business systems and industry requirements.
• Provide expertise in identifying, evaluating and developing systems and procedures that meet user requirements and are within stated sizing estimates.
• Configure system settings and options; plan and execute business design, assist in integration and acceptance testing, where necessary; and create specifications for system to meet business requirements.
• Include analysis of business and user needs, documentation of requirements, and translation into proper system requirement specifications.
• Begins to develop working relationships with client end-users, programmers and test analysts while assisting with the analysis, design, configuration, testing and maintenance of systems.
• Maintains communications with end-users for feedback to ensure systems continually meet the client's expectations.
• Analyzes basic problems and issues (complexity varies based on data requirements and business specifications) and offers standard business solutions.
• Coordinates and facilitates client meetings.
• Develops simple business specifications and logical flowcharts that include features and functions from which programmers can create technical specifications.
• Demonstrates a basic knowledge of systems/modules to design system screens and database structures.
• Works with programmers to design and develop requirements and learns to analyze the feasibility of new systems and enhancements to existing systems.
• Prepares input for system design, including final report and screen definition, logical system flow and implementation plans.
• Provides support with the resolution of issues that may cross multiple systems and affect the business process and tracking of application incidents/issues; becomes familiar with how to identify system impact of changes in the business, user needs, external business environment and operating systems.
• Develops documentation to include, but not limited to bulletins, manuals, file layouts and application design layouts for internal, client and training purposes.
• Assists with the preparation and coordination of client training and documentation for installation of systems and upgrades.
• Tracks and learns to document changes for functional and business specifications; writes detailed, universally understood procedures for permanent records and for use in training.
• Assists with coordinating documentation and client follow-up evaluation monitoring; post-implementation problems and revision requests.
• Maintains and administers procedures, methodology and/or application standards to include payment card industry and security related compliance.
• Demonstrates a working knowledge to conduct and support testing/planning/validation by clarifying the intended functionality.
• Participates in the resolution of issues to ensure a successful implementation.
• Tests and learns to analyze possible courses of action and solutions.
• Assists with coordinating implementations including vendor and in-house testing, readiness assessment, training and hardware capacity evaluation.
• Assists with the project planning efforts on small development efforts.
• Tracks project progress, collects and analyzes information and trends, and communicates to the user community any anticipated schedule deviations.
• Maintains software deployment plans as directed.

• Support the development and enhancement of various AI/ML products for partner Blues plans to help process claims
• Work in an Agile Scrum environment
• Utilize technologies such as Snowflake, AWS Bedrock, and Amazon SageMaker
• Work from 7 or 8 am to 5 PM EST core business hours

Senior Business Analyst

• Conduct the annual Health Risk Survey to support needs identification for the member’s Individual Plan of Care.
• Inform the assigned care manager of newly identified health/safety risks or service needs
• Complete care coordination activities delegated by the care manager within an established timeframe.
• inform the assigned care manager and/or associate manager of any identified quality of care issues.
• Passionately support the member’s care coordination needs and drive solutions to address those needs.
• Use problem-solving skills to find alternative contact information for members who are unreachable by care management.
• Employ motivational interviewing techniques to maximize member engagement and promote lifestyle changes for optimal health.
• Adhere to case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies.

Case Management Analyst

• Provides analytical support while serving to help identify the scope and objectives of project engagements.
• Remain focused on performance measures and indicators.
• Serves as analytical resource on engagement team by helping to formulate and define systems scope and objectives through research and fact-finding combined with a basic understanding of business systems and industry requirements.
• Assumes responsibility for analyzing and documenting data, conducting extensive research, and integrating business solutions.
• Performs financial and data modeling, evaluates current processes, and prepares appropriate documentation for client.
• Maintains accountability for process deliverables and business presentations to client.
• Develop Report and Data Analysis Requirements

Business Analyst, Master Degree Required

• Identify, map, measure, analyze and improve routine to moderately complex clinical and business processes
• Perform current and future workflow analysis and map out critical business processes
• Prepare documentation for business requirements by using case diagrams, data flow diagrams, data models, and object models
• Evaluate whether a proposed solution meets the business and clinical needs
• Translate user requirements into functional and technical design specifications
• Develop test plans, test cases, and test scripts to validate performance of all functions
• Conduct effective unit, integration, system and end-user acceptance testing through execution of the tests
• Provide client and support training through development of training materials
• Monitor system functionality and clinical and business processes instituting changes as needed

IT Business Analyst – Finance & Supply Chain

• Gather, document and organize requirements from CMS regulatory documentation
• Support facilitation of client discovery sessions and work stream meetings (creating materials, back-up to PO)
• Assist with creation and maintenance of workflows
• Create deliverables
• Assist PO with other program activities and deliverables such as: IRAADQ resolution / follow-up, writing features and user acceptance criteria

Business Analyst, Optum Experience

• Collaborate with cross-function teams such as Product, Distribution, Marketing and Legal & Compliance to gather input on product features, process improvements, sales needs and regulatory requirements.
• Translate complex inputs into clear and actionable business and functional specs.
• Work with technical teams to implement and test changes and enhancements to ensure digital outputs are compliant, accurate and customer friendly.
• Create and maintain detailed user stories, acceptance criteria, and backlog items in tools like JIRA.
• Research issues raised by internal stakeholders and work with internal and/or external IT team to identify solutions and document requirements for changes.
• Build reports to monitor system performance and identify rooms for improvement.
• Assist with UAT testing and obtain required software release approvals.
• Communicate regular updates with internal and external team members.
• Monitor industry trends, regulatory changes, competitor updates as well as customer feedback to recommend enhancements that improve our process and value proposition.

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