IL
BA – Healthcare Specialist
ICONMA, LLC
🇺🇸 United States
Remote
1 month ago
$45 – $50 / hour
- AI
- Jira
- prior authorization
- Health insurance
1 month ago
Responsibilities:
- Healthcare Business Process Analyst Responsibilities
- Facilitate Business Process Assessment (BPA) sessions and serve as the BPA lead for one or more SHP project workstreams.
- Evaluate existing healthcare business processes, operating procedures, and organizational workflows.
- Conduct process discovery workshops and stakeholder interviews to gather, analyze, and validate business requirements.
- Document current-state and future-state processes using process maps, swim lane diagrams, and workflow documentation.
- Identify process bottlenecks, operational inefficiencies, risks, and control gaps, and perform root cause analysis.
- Recommend and drive process improvements, automation opportunities, standardization initiatives, and corrective actions.
- Collaborate with business, operations, and technology teams to improve process effectiveness, operational efficiency, and service quality.
- Present process findings, recommendations, and transformation roadmaps to leadership and key stakeholders.
- Support digital transformation, business process automation, workflow modernization, BPM, and AI-enabled initiatives.
- Participate in solution implementation, User Acceptance Testing (UAT), and operational readiness activities to ensure successful adoption and transition.
- Develop and maintain:
- Business Process Documents
- Standard Operating Procedures (SOPs)
- Workflow Diagrams
- Business Rules Documentation
- Decision Trees
- Process Metrics and KPIs
- Ensure process artifacts remain current and comply with organizational standards.
Requirements:
- Must have Skills: Healthcare Payer
- Good to have skill: Facets/ ALM experience /Jira
- Healthcare Domain Knowledge
- Health Insurance Operations
- Claims Adjudication
- Prior Authorization
- Member Services
- Provider Network Management
- Medicare & Medicaid Programs
- Healthcare Regulatory Requirements
Why Should You Apply?
- Health Benefits
- Referral Program
- Excellent growth and advancement opportunities
BA – Healthcare Specialist · ICONMA, LLC