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20 jobs similar to Senior Business Analyst, Government Programs Operations Claims & Encounters

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$95,000–$110,000/yr
US

  • Gather, analyze, and document requirements for business projects and process improvements.
  • Collaborate with stakeholders to understand business objectives, workflows, and needs.
  • Translate business requirements into functional specifications for development and implementation.

Point C is a national third-party administrator (TPA) with local market presence that delivers customized self-funded benefit programs. They focus on effective cost containment strategies and innovative solutions. The company values diversity and inclusivity.

US 3w PTO

  • Own data reconciliation and reporting workflows.
  • Gather, validate, and prepare data from multiple sources.
  • Identify missing or inconsistent fields and partner with Operations to resolve issues.

Zócalo Health is the first tech-driven provider built specifically for Latinos, by Latinos, developing a new approach to care designed around shared and lived experiences. Founded in 2021, they are backed by leading healthcare and social impact investors.

  • Engage in requirements elicitation and management
  • Evaluate business processes and develop optimization strategies
  • Ensure solutions meet business needs and requirements

Exadel is an AI-first global tech company with 25+ years of engineering leadership and 2,000+ team members. They partner with enterprise leaders to build what’s next, and they cultivate an ambitious, collaborative, and constantly evolving culture.

US

  • Engage business stakeholders, federal health clients, data science, and engineering teams.
  • Elicit, document, and manage both business requirements and system requirement specifications.
  • Lead development of Business Requirements Documents (BRD) and System Requirement Specifications (SRS).

International Consulting Associates, Inc. helps government clients with evaluating and achieving their objectives. They are a rapidly growing company located in the D.C./Metro area fostering a collaborative "one team" environment where work-life balance is prioritized.

$55,748–$76,659/yr
North America

  • Elicit information from stakeholders and examine business needs.
  • Lead evaluation of current and future state processes and document requirements.
  • Collaborate with stakeholders to determine project scope and translate requirements.

OTIP Group of Companies provides meaningful benefits support and service. They value employees and aim to create an inclusive work environment where everyone feels supported and included.

US

  • Provide centralized, remote support to the Department of Veterans Affairs (VA) Dental Pilot Program.
  • Coordinate meetings, training sessions, and conferences; plan and schedule mobile clinic operations where applicable.
  • Identify inefficiencies and bottlenecks; document process updates; support implementation of quality control measures.

International SOS Government Medical Services, Inc. delivers customized medical and security risk management and wellbeing solutions to enable our clients to operate safely and effectively in environments far from home. With 12,000 staff (including 5,200 medical and behavioral health providers) they provide healthcare support to Government defense and civil agencies and government contractors.

$135,000–$150,000/yr
US

  • Drive successful implementation and optimization of healthcare claims software solutions.
  • Deliver mid- to complex software projects, accurately forecasting and scheduling deliverables.
  • Engage with clients to understand their needs and support the design of tailored software solutions.

HealthEdge provides technology that enables healthcare payors to leverage new business models, improve outcomes, reduce administrative costs, and connect everyone in the healthcare delivery cycle. HealthEdge's enterprise product suite is built on modern, patented technology and is delivered to customers via the HealthEdge Cloud or on-site deployment; they are an award-winning company.

  • Engage with stakeholders to gather requirements.
  • Translate business needs into structured BRDs.
  • Identify gaps and recommend process improvements.

Rakuten Kobo Inc. is the world’s digital bookseller created by and for booklovers. Owned by Tokyo-based Rakuten Group, Inc. and headquartered in Toronto, Rakuten Kobo’s millions of worldwide users can read anytime, anywhere, and on any device.

$145,000–$160,000/yr
US

  • Use your healthcare knowledge to proactively identify unexpected changes in data and investigate root causes by analyzing trends and underlying factors.
  • Turn insights into actions, transforming your findings into clear recommendations for strategic adjustments, workflow improvements, and smarter investments.
  • Design, build, and own the development and communication of KPIs for the Provider Operations and Provider Performance teams.

Devoted Health is on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. Founded in 2017, they've grown fast and now serve members across the United States.

$80,000–$90,000/yr
US

  • Collect, clean, process, and analyze potential and current clients’ pharmaceutical data using SQL, R, Python, and MS Excel.
  • Thoroughly understand internal and external data fields, identify patterns of data irregularities, and improve data quality and intake.
  • Assist in the writing and maintenance of the Underwriting infrastructure code in SQL, R, and Python.

Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans. The company aims to rebuild trust in healthcare in the U.S. and deploy the infrastructure we need for the care we deserve; they have a startup energy with a focus on delivery.

US 3w PTO

  • Support implementation teams with deployment of Experian's ClaimSource revenue cycle management system.
  • Analyze internal processes and recommend improvements to enhance efficiency, automation, and effectiveness.
  • Build strong relationships with clients and implementation/service teams; participate in regular client calls.

Experian is a global data and technology company, powering opportunities for people and businesses around the world. We operate across a range of markets and have a team of 23,300 people across 32 countries, investing in people and new advanced technologies to unlock the power of data and to innovate.

$125,000–$135,000/yr
US

  • Developing advanced analyses of health plan and employer data.
  • Translating data into actionable strategies that support value-based care.
  • Building repeatable, intuitive reports and dashboards.

Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. They aim to make healthcare affordable, improve patient health, and restore fulfillment in practicing medicine for providers. Driven by empathy and AI, Guidehealth leverages Healthguides™ and a Managed Service Organization to build stronger connections with patients and providers.

North America

  • Gather and document business and functional requirements for the NOW Engage platform via stakeholder input and process review.
  • Review current delivery workflows to find inefficiencies and areas for improvement.
  • Build relationships with key stakeholders.

ServiceNow is a global market leader that brings innovative AI-enhanced technology to over 8,100 customers. They empower organizations to find smarter, faster, and better ways to work by seamlessly connecting people, systems, and processes in the cloud.

$74,080–$133,900/yr

  • Collect, evaluate, and communicate business requirements.
  • Perform analysis and engage appropriate department members.
  • Define system requirements, testing, implementation, and support.

FM is a leading mutual insurance company dedicated to property risk management and the resilience of its policyholder-owners. They work with organizations to understand hazards and make cost-effective risk management decisions, combining property loss prevention with insurance protection.

US

  • Elicit and document business requirements, ensuring accuracy and effective communication.
  • Conduct gap analysis of existing system functionality against desired functionality.
  • Collaborate daily with the Senior Systems Advisor to track development and test system functionality.

Vtekis provides Recruitment and Staffing services to many industries through innovative and customized solutions and passionate commitment to research. They're trusted business partners and always strive to deliver the most value and highest return on investment for their clients.

US

  • Partner with program managers, domain experts, and end users to gather and clarify business and functional data requirements.
  • Review existing data workflows and business processes to identify inefficiencies, delays, or manual workarounds.
  • Analyze integrated datasets to produce insights that support operational and leadership decisions.

Rackner is a cloud-native software consultancy delivering solutions for startups, enterprises, and the public sector. They enable digital transformation through DevSecOps, AI/ML, and cloud-first innovation.

US

  • Maintain the AthenaIDX practice management system.
  • Translate business needs into system updates.
  • Troubleshoot errors and support third-party vendors.

Jobgether uses an AI-powered matching process to ensure applications are reviewed quickly, objectively, and fairly against the role's core requirements. Their system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company.

Unlimited PTO

  • Serve as a technical expert and end-to-end owner of care experience data, core metrics, and business reporting
  • Partner with Care Experience, Clinical, Product, and Engineering teams to define, track, and improve core business and care KPIs
  • Investigate care performance trends, operational issues, and data anomalies, and turn findings into clear, actionable recommendations

Hims & Hers is a health and wellness platform that aims to improve people's well-being through better health by providing affordable and personalized care. They are a public company traded on the NYSE under the ticker symbol “HIMS” and they have a talent-first flexible/remote work approach.

US

  • Use business requirements to develop BI solutions, including ad hoc operational and analytical reports, dashboards, scheduled reports.
  • Provide issue resolution during Quality Assurance / User testing, troubleshoot and analyze data processing failures and data issues.
  • Conduct discovery sessions with end users, front line staff, leadership, analysts, engineers and informaticians to gather and document detailed requirements.

The Information Technology Group (ITG) provides and supports technology and information services for OHSU. Their work ensures that the informational assets of the OHSU enterprise are leveraged to enhance financial, clinical, operational, and research decision-making.

US 3w PTO

  • Own the strategy, execution, and monitoring of all sales analytics in our CRM
  • Design, develop and implement functional dashboards, visualizations and reports to produce a suite of metrics and analytics to monitor progress
  • Serve as the primary stakeholder for all Payer-oriented analytics

Alma's mission is to simplify access to high-quality, affordable mental health care by making it easy for therapists to accept insurance. They are available in all 50 states, with over 20,000 therapists in their growing network and have raised $220.5M in funding.