Senior Business Analyst, Government Programs Operations Claims & Encounters

About Judi Health

Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including:

• Capital Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers
• Judi Health, which offers full-service health benefit management solutions to employers, TPAs, and health plans
• Judi, the industry’s leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform

Together with our clients, we’re rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve. To learn more, visit

Hybrid (Local to New York, NY, Denver, CO or Charlotte, NC)

Position Summary

The Business Analyst provides support gathering and documenting business and reporting requirements that align with state and federal guidelines. The role analyzes complex problems and issues using available information from both internal and external sources. Responsibilities also include creating specifications documents for business processes, reports, data extracts, and analyses based on business needs, identifying and interpreting trends in datasets to uncover outliers or patterns that can drive process improvements. The Business Analyst collaborates with internal and external cross‑functional teams (compliance, product, sales, marketing, underwriting, implementation, client services, clinical operations) to design, refine, automate, and maintain operational capabilities.

Position Responsibilities

• Monitor changes in existing business processes and update documentation accordingly, finding new opportunities for process developments and improvements.
• Intake, analyze, and manage requests from stakeholders.
• Proactively review business processes and data to develop subject‑matter expertise of processes supported by the team.
• Drive root‑cause analysis and resolution of data and process issues/errors in partnership with key stakeholders.
• Support analytical, problem‑solving functions by defining and documenting specifications pertinent to all departmental processes.
• Analyze business workflow and system needs for conversions and migrations to ensure that government submissions, recovery, and cost‑saving regulations are met.
• Prepare end‑user documentation and training materials as needed.
• Support government data submission processes by analyzing complex data issues using data from internal and external sources.
• Improve government data submission processes by reviewing and synthesizing state and federal resources, consolidating into comprehensive business requirements documents.
• Support creation of intake requests to enhance existing processes by gathering requirements and level‑setting with stakeholders on required processes.
• Develop and set up performance metrics for stakeholder distribution.
• Perform root‑cause analysis of government data processing and submission issues; develop recommendations based on data and industry knowledge.

Minimum Qualifications

• 3+ years of healthcare experience.
• 3+ years of business process analysis, preferably in healthcare.
• 3+ years of experience with Government Exchange programs.
• Demonstrable knowledge of SQL, Excel, and flow‑charting tools.
• Experience with implementation/project management.
• Experience working with cross‑functional teams.
• Extremely flexible, highly organized, excellent communicator able to shift priorities easily.
• Attention to detail and commitment to delivering high‑quality work product.
• Comfortable in a fast‑paced, growing environment.
• Intellectual and professional curiosity.
• Familiarity with the agile framework/Certified Scrum Product Owner preferred.
• Bachelor’s degree in Business Administration, Data Analytics, Computer Science, or 3+ years of relevant experience.

Salary Range

New York, NY: $135,000—$146,000 USD
Denver, CO: $125,000—$135,000 USD
Charlotte, NC: $115,000—$125,000 USD

Equal Employment Opportunity Statement

All employees are responsible for adherence to the Capital Rx Code of Conduct including the reporting of non‑compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.

We provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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