Job Description
Job Description
**This position can be fully remote but must work PST hours**
- Partner with business stakeholders to elicit, document, and validate business and functional requirements for health plan initiatives.
- Analyze and document current state and future state workflows related to claims processing, enrollment, eligibility, benefits configuration, care management, and provider data.
- Translate business requirements into functional specifications, user stories, and acceptance criteria for technical teams.
- Support system enhancements, implementations, and optimizations across core health plan platforms (e.g., claims, enrollment, provider, clinical, or reporting systems).
- Facilitate stakeholder meetings, working sessions, and JAD sessions to ensure alignment and clarity.
- Ensure solutions align with regulatory and compliance requirements (e.g., CMS, HIPAA, state mandates).
- Create and maintain documentation including process flows, data mapping...
**This position can be fully remote but must work PST hours**
- Partner with business stakeholders to elicit, document, and validate business and functional requirements for health plan initiatives.
- Analyze and document current state and future state workflows related to claims processing, enrollment, eligibility, benefits configuration, care management, and provider data.
- Translate business requirements into functional specifications, user stories, and acceptance criteria for technical teams.
- Support system enhancements, implementations, and optimizations across core health plan platforms (e.g., claims, enrollment, provider, clinical, or reporting systems).
- Facilitate stakeholder meetings, working sessions, and JAD sessions to ensure alignment and clarity.
- Ensure solutions align with regulatory and compliance requirements (e.g., CMS, HIPAA, state mandates).
- Create and maintain documentation including process flows, data mapping...