Job Description :



Please look for Payor client s experince



Study the existing system/application and document AS-IS functionality using process flow and data flow diagrams.



Participate in requirement gathering sessions and document requirements /functional specifications.



Understanding of business process on Claim Processing, Membership, Premium Billing etc



Conduct JAD with business and other stake holders to capture the requirements.



Should have experince in Payer HEDIS programs and Care management



Work experience in Blues payer is added advantage.



Experience FEP payer market is added advantage.



Identify gaps in requirements and perform further analysis to ensure accuracy in the requirements.



Develop solutions/Perform solution assessment to check if the proposed solution meets the requirements and all healthcare regulations are adhered to.



Create design documents in alignment with business requirements.



Discuss the solution with the architect, database, and technical experts to know if there are any technical framework constrains to implement the solution.



Work closely with the product management team and POs while preparing backlog , prioritizing features and agree on the timeline for the completion of each feature.



Confirm and document the scope and limitations of the proposed solution.



Work closely with the Development and QA team to review the feature/User story functionality to ensure all scenarios are covered by Dev and QA in their testing.



Perform testing of the application/Data to ensure that the proposed solution is appropriately implemented and recommend changes to Dev and QA if required



Experience in Leading Jr SA, review, and provide direction to them on their work products



Diverse Lynx LLC is an Equal Employment Opportunity employer. All qualified applicants will receive due consideration for employment without any discrimination. All applicants will be evaluated solely on the basis of their ability, competence and their proven capability to perform the functions outlined in the corresponding role. We promote and support a diverse workforce across all levels in the company.