- Act as the SME for Coordination of Benefits operations, payer enrollment processing, primacy determination, overlap management, and member eligibility workflows.
- Lead workshops with payer operations, business users, product owners, and executive stakeholders.
- Analyze and rationalize existing COB business processes and operational workflows.
- Interpret and document NAIC COB guidelines, Medicare Secondary Payer (MSP) rules, Medicaid regulations, and state-specific COB requirements.
- Drive business rule governance and establish traceability from regulations to platform implementation.
- Define future-state business capabilities for modernized COB ecosystems
Requirements & AI-assisted Business Analysis :
- Conduct current-state and future-state assessments.
- Facilitate business process modeling, gap analysis, and impact assessments.
- Develop BRDs, FRDs, user stories, use cases, process flows, and acceptance criteria.
- Translate complex business requirements into epics, features, and detailed user stories.
- Manage requirements traceability throughout the SDLC.
- Define MVP scope and release-level business priorities.
- Leverage Generative AI platforms (ChatGPT, Claude, Copilot, Gemini, etc.) to accelerate:
- User story generation
- Process documentation
- Acceptance criteria creation
- Business rule extraction
- Utilize AI-assisted analysis techniques to reverse engineer legacy COB applications and uncover hidden business logic.
We are an equal opportunity employer. All aspects of employment including the decision to hire, promote, discipline, or discharge, will be based on merit, competence, performance, and business needs. We do not discriminate on the basis of race, color, religion, marital status, age, national origin, ancestry, physical or mental disability, medical condition, pregnancy, genetic information, gender, sexual orientation, gender identity or expression, national origin, citizenship/ immigration status, veteran status, or any other status protected under federal, state, or local law.
#J-18808-LjbffrBusiness analyst in washington at Unknown Company
This position is listed as full time and onsite.