Business Rules Analyst
5 - 7 years experience • Managed Care & Health Insurance
As a Business Analyst I you will analyze the business needs and develop, document, and implement business rules to resolve issues and improve processes through use of a rules engine tool.
Characteristics and Responsibilities
- Analyze business needs through direct input from customers and system research to identify solutions, assess solutions and business rules, and document business rules using a standardized requirements documentation method.
- Utilize a rules engine tool to author, implement, and maintain business rules in claims processing system.
- Lead business rules projects through entire project lifecycle to ensure accuracy and effectiveness of rules and Service Level Agreement timelines are met.
- Monitor business rules’ effects on Production claims processing system and assess to validate functionality, perform root cause analysis, and identify opportunities for improvements.
- Perform testing and test support activities, including providing direction on testing needed, executing test cases to verify business rules effectiveness, identifying and analyzing issues, and determining and implementing resolutions.
- Identify resource needs and coordinate prioritization and scheduling of resources (time, staff, and technology) for business rules requests.
- Utilize a project management tool to create and communicate project status reports to customers.
- Construct and maintain a business rules repository of all business rules implemented through rules engine tool.
- Provide training and instruction to develop junior staff and educate Operations areas, including creating training materials, assessing decisions made by junior staff, and providing guidance and approval.
- Assess, update, and maintain business processes following ISO standards, including policies, workflow, and work instructions.
- 4years or more of business experience in MVH Operations, including working as a Subject Matter Expert in Systems Projects
- Prior business rules analysis experiencepreferred
- Bachelor’s degree in Information Systems, Business Administration, Data Processing, Business Management
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities