[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 plus Benefits • 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 role Company 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 is Company 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