Senior Healthcare Business Analyst

LanceSoft, Inc. is seeking a Senior Healthcare Business Analyst and Behavioral Health SME to support payer transformation initiatives. The role bridges business and technology teams by applying expertise in Behavioral Health operations, end-to-end payer processes, healthcare regulations, business analysis, payer platforms, healthcare transactions, data analysis, and system integration.

Responsibilities:

• Support payer transformation initiatives
• Requirements gathering
• BRD/FRD/User Stories
• Process mapping
• Gap analysis
• UAT/SIT support
• Stakeholder management

Requirements:

• 10+ years of Healthcare Payer experience with 5+ years in Behavioral Health (Mental Health & Substance Use Disorders)
• Strong understanding of the end-to-end payer lifecycle :
• Deep knowledge of Behavioral Health regulations , including:
• Strong Business Analysis skills:
• Experience with payer platforms such as Facets, QNXT, HealthRules, GuidingCare, TruCare, or similar
• Knowledge of healthcare transactions and interoperability standards:
• Strong SQL, data analysis, and system integration understanding
• Experience with Commercial, Medicare, and Medicaid lines of business
• Exposure to Behavioral Health care management, utilization management, and value-based care programs
• Experience working on payer modernization, data, AI , or digital transformation initiatives