Senior Business Systems Analyst (Healthcare Payer COB SME)

• 18+ years of overall Business Analysis experience with 10+ years focused on Healthcare Payer operations and at least 7+ years in Coordination of Benefits (COB), Eligibility, Enrollment, and Member Data Management domains.

• Deep domain expertise in:
  • Coordination of Benefits (COB)
  • Primacy Determination
  • Enrollment & Eligibility
  • Medicare Secondary Payer (MSP)
  • Medicaid Coordination Rules
  • NAIC COB Guidelines
  • Healthcare Payer Operations
  • Member Matching / EMPI
  • Provider and Payer Ecosystems

• Strong SQL and data analysis capabilities.
• Experience analyzing complex healthcare datasets.
• Familiarity with Azure-based data platforms and modern cloud ecosystems.
• Understanding of API-driven architecture and microservices.
• Hands-on experience with HL7 and FHIR standards.

Business Analysis Skills

• Expert in requirements elicitation and stakeholder management.
• Strong process modeling skills (BPMN, Visio, Lucidchart, etc.).
• Experience working within Agile/Scrum and SAFe delivery models.
• Strong documentation and communication capabilities.