Immediate Requirement: Business Analyst (Healthcare Payer) — Louisville, Kentucky – Long Term

[Lorven Technologies Inc]

Good Day,

 

Our client is looking for a Business Analyst (Healthcare Payer) in Louisville, Kentucky, below is the detailed requirement, If you have any consultants available for the below position, please forward their updated resume to pa...@lorventech.com

 

Job Title: Business Analyst (Healthcare Payer)

Location: Louisville, Kentucky

Duration: Long Term

 

Job Description:

·         Bachelor's degree in Business Administration, Healthcare Administration, Information Systems, or a related field.

·         Strong experience in healthcare payer operations and business analysis.

·         Deep understanding of healthcare payer functions, including:

·         Enrollment and Eligibility

·         Claims Processing and Adjudication

·         Provider Network and Contract Management

·         Utilization Management

·         Care Management

·         Customer Service Operations

·         Payment Integrity

·         Appeals and Grievances

·         Experience gathering and documenting business and functional requirements.

·         Strong analytical, communication, facilitation, and stakeholder management skills.

·         Experience working in Agile and Waterfall delivery environments.

Preferred Qualifications

·         Experience with Medicare, Medicaid, Commercial, and Dual-Eligible healthcare programs.

·         Knowledge of healthcare standards such as FHIR, HL7, EDI X12, HEDIS, STAR Ratings, and CMS regulations.

·         Experience supporting payer modernization, digital transformation, data management, analytics, or AI-enabled initiatives.

 

 

 

 

 

 

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Thanks & Regards

 

Paul Uttam Raj,

Lorven Technologies, Inc.

101 Morgan Lane | Suite 209 | Plainsboro | NJ 08536

Email: pa...@lorventech.com | Web: www.lorventech.com