Business Analyst (ORMB)
SGA
Software Guidance & Assistance, Inc., (SGA), is searching for an ORMB Business Analyst for a right-to-hire assignment with one of our premier Insurance Clients clients in Hartford, CT on a hybrid work schedule. Will consider remote worker on the east coast if a perfectly aligned candidate:
We are seeking a Senior Business Analyst with deep expertise in insurance billing, commissions, and Oracle Revenue Management and Billing (ORMB) to lead the functional design and delivery of enterprise billing solutions. This individual will serve as a critical liaison between business and technology teams, helping define future-state billing capabilities and ensuring successful implementation across the full project lifecycle.
The ideal candidate will possess strong functional knowledge of Employee Benefits and Group Billing operations, hands-on ORMB experience, and a proven ability to translate complex business requirements into scalable billing and revenue management solutions.
Business Analysis & Functional Design
- Lead current-state assessments and future-state design efforts for insurance billing and revenue management processes.
- nalyze and document requirements related to:
- Group and member billing
- Products, plans, and benefits
- Premium calculation and rating
- Invoicing and bill composition
- Payments, adjustments, refunds, receivables, and financial controls
- Define end-to-end ORMB functional requirements, including product configuration, pricing structures, billing rules, and algorithms.
- Perform gap analysis, evaluate solution alternatives, and drive design decisions with business and technical stakeholders.
- Create detailed functional specifications, process flows, and data mapping documentation.
- Partner closely with business stakeholders, subject matter experts, and Agile Product Owners to gather, refine, and prioritize requirements.
- Translate features into detailed user stories with clear acceptance criteria.
- Participate in Agile ceremonies including backlog refinement, sprint planning, reviews, and retrospectives.
- Facilitate workshops, design sessions, and stakeholder meetings.
- Present solution designs and conduct demonstrations for business and project teams.
- Design and validate complex billing scenarios, including:
- Retroactive changes
- Cancellations and reinstatements
- Refunds and write-offs
- Dunning and collections processes
- Collaborate with QA and UAT teams to develop comprehensive end-to-end test scenarios.
- Support testing strategy development, defect triage, root cause analysis, and issue resolution.
- Ensure complete traceability between business requirements, configuration, testing, and delivery.
- Support solution design for integrations between policy administration systems, financial platforms, and ORMB.
- Develop data mapping, conversion requirements, and interface specifications.
- Partner with technical teams on custom components, reporting, batch processing, and data migration activities.
- Provide support for production operations, incident management, and problem resolution activities.
- Serve as a functional leader for billing initiatives and a trusted advisor to business stakeholders.
- Mentor junior analysts and team members on insurance billing processes and ORMB best practices.
- Promote quality standards, delivery discipline, and continuous improvement across project teams.
- 5+ years of Business Analysis experience supporting insurance or healthcare payer billing solutions.
- Hands-on functional experience implementing and supporting Oracle Revenue Management and Billing (ORMB).
- Strong expertise in:
- Employee Benefits Group Billing
- Premium-based billing
- Invoicing and receivables
- Payments, adjustments, refunds, and financial controls
- Demonstrated ability to translate business requirements into functional designs and ORMB configurations.
- Experience conducting stakeholder workshops and facilitating complex business discussions.
- Strong analytical, documentation, and problem-solving skills.
- Working knowledge of SQL for analysis and troubleshooting.
- Experience working in Agile, Scrum, or SAFe environments.
- Experience supporting production systems, incident management, and problem resolution processes.
- Bachelor's degree in Business, Information Systems, Computer Science, or a related discipline, or equivalent experience.
- Experience within Employee Benefits, Group Insurance, or Healthcare Payer organizations.
- Knowledge of billing commissions and revenue management processes.
- Experience with ServiceNow or similar production support tools.
- Familiarity with Oracle billing data models and integration architectures.
- Prior experience supporting large-scale billing transformation initiatives.
- Strong partnership with business and technology stakeholders.
- Well-defined, testable requirements that reduce delivery risk and rework.
- ccurate and maintainable ORMB configurations that support complex billing scenarios.
- Full traceability from business objectives through design, testing, and deployment.
- Successful production implementations with strong user adoption and operational stability.
- Effective management of risks, issues, and stakeholder expectations throughout the project lifecycle
SGA is an Equal Opportunity Employer and does not discriminate on the basis of Race, Color, Sex, Sexual Orientation, Gender Identity, Religion, National Origin, Disability, Veteran Status, Age, Marital Status, Pregnancy, Genetic Information, or Other Legally Protected Status. We are committed to providing access, equal opportunity, and reasonable accommodation for individuals with disabilities in employment, and our services, programs, and activities. Please visit our company EEO page to request an accommodation or assistance regarding our policy.
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