Required Skills

Business Analyst

Work Authorization

  • US Citizen

  • Green Card

  • EAD (OPT/CPT/GC/H4)

  • H1B Work Permit

Preferred Employment

  • Corp-Corp

  • W2-Permanent

  • W2-Contract

  • Contract to Hire

Employment Type

  • Consulting/Contract

education qualification

  • UG :- - Not Required

  • PG :- - Not Required

Other Information

  • No of position :- ( 1 )

  • Post :- 5th Jan 2024

JOB DETAIL

  • Looking for Business Analys’s with  healthcare knowledge, understand the directory, and worked on mandates.
  • Open to mandate exp from any state but ultimate plus is mandates from MA
  • Any experience working with third party vendors
  • Collection vendor = CAQH
  • Provider Directory vendor = Zelis/Saphire Digital
  • 22 Blue plans use them as a vendor
  • They would probably know the CMS mandates
  • They will present back and forth – not one side vs. the other
  • Balance of understanding systems and business
  • CAQH will send files to BCBSMA, they ingest into their system and then they store them (turned into file)
  • Some process pulls all the files/provider data which get organized and displayed
  • Understand apps, data and flow of data
  • Some of the regulations are process related, not technical
  • Project Manager will be similar profile/requirements but product focused.
  • They are not totally sure how Agile this will be run
  • Tough to be Agile with the vendor balance
  • Big benefit to be able to run in both and flexible to delivery requirements

 

Company Information