Healthcare Business Systems Analyst

Healthcare Business Systems Analyst

Location:- Woodland Hills, CA

Duration:- Full Time

Job Description

Must Have Technical/Functional Skills

We are seeking an experienced Business Systems Analyst with strong healthcare domain expertise to support payer-side business and technology initiatives. The analyst will work closely with business stakeholders, product owners, and technical teams to translate complex healthcare business requirements into clear functional and system specifications across multiple core domains including Claims, Enrollment, Membership, Benefits, Provider, and Billing.

Key Skills

Business Systems Analyst experienced in healthcare domains, including Claims, Enrollment, Membership, Benefits, Provider, and Billing.

Roles & Responsibilities

• Analyze, and document business and system requirements across healthcare payer domains such as Claims, Enrollment, Membership, Benefits, Provider Management, and Billing.
• Collaborate with business users, SMEs, and technical teams to understand end to end healthcare workflows and operational processes.
• Translate business needs into functional specifications, system requirements, user stories, use cases, process flows, and acceptance criteria.
• Support system design discussions by validating requirements, identifying gaps, and ensuring alignment with business objectives.
• Perform impact analysis for changes across upstream and downstream systems.
• Participate in Agile ceremonies including backlog grooming, sprint planning, and sprint reviews.
• Support UAT planning and execution, including test scenario creation, defect triage, and validation of fixes.
• Ensure compliance with healthcare regulations and standards (e.g., HIPAA, EDI transactions such as 834, 837, 835 knowledge preferred).
• Work closely with data, integration, and QA teams to support requirement clarification and delivery readiness.