[Remote] Healthcare Business System Analyst

Note:The job is a remote job and is open to candidates in USA. UST HealthProof is a trusted partner for health plans, offering integrated ecosystem solutions for health plan operations. They are seeking a Healthcare Business System Analyst to capture business requirements and implement their core-admin ecosystem, while managing stakeholder communications and developing functional requirements for various healthcare systems. Responsibilities• Leading business requirement conversations with customer and internal teams.• Managing the end-to-end requirements involving all the stakeholders. • Responsible for developing business and functional requirements for Claims, Enrollment, Provider, Authorization, Payment systems. • Create solutions for current business processes using HealthProof’s core-admin ecosystem. • Negotiate with client to develop processes that are current and applicable to the situation. Skills• Bachelor’s degree or higher in business or technical field• 7+ years of relevant work experience in business analysis• Knowledgeable in Healthcare insurance domain (Medicare, Medicare Advantage, Medicaid, ACA or Commercial)• Experience with mapping of EDI healthcare transactions (837, 834, 835,270/271, 276/277, 278)• Experience in analysing the business requirements and translating/mapping them to technical requirements in EDI technology by analysing implementation/companion/TR3 guides• Experience documenting requirements or user stories and communicating the requirements to technical teams, partners/vendors or product teams• Experience working in an onshore/offshore model is a must• Skills & Competencies: Awareness to Agile tools and scrum methodologies• Communication skills with peers, customers, and partners including the ability to convey information effectively• Experience working HealthEdge applications like HealthRules Payor or GuidingCare is a plus• Understanding of SQL, XSDs is a plusBenefits• Full-time, regular employees accrue up to 16 days of paid vacation per year• Receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year)• 10 paid holidays• Eligible for paid bereavement leave• Eligible to participate in the Company’s 401(k) Retirement Plan with employer matching• Eligible for medical, dental, and vision insurance• Basic life insurance• Accidental death and disability insurance• Short- and long-term disability benefits• May purchase additional voluntary short-term disability benefits• Participate in a Health Savings Account (HSA)• Flexible Spending Account (FSA) for healthcare, dependent child care, and/or commuting expenses• Potential for quarterly incentive-based bonuses and or commissions depending on roleCompany Overview• UST HealthProof offers risk adjustment, quality programs, and healthcare payer technology services.It is a sub-organization of UST. It was founded in undefined, and is headquartered in Aliso Viejo, California, USA, with a workforce of 501-1000 employees. Its website isCompany H1B Sponsorship• UST HealthProof has a track record of offering H1B sponsorships, with 40 in 2025, 43 in 2024, 31 in 2023, 3 in 2022. Please note that this does not guarantee sponsorship for this specific role. Apply tot his job