Health New England is seeking a Business Transformation System Analyst to drive technology-enabled transformation, payment integrity, and operational excellence across our claims administration environment in Springfield, MA.

RESPONSIBILITIES:

The Business Transformation System Analyst serves as a key bridge between business teams, technology, and vendors, turning complex business needs into effective system solutions. You'll play a critical role in analyzing workflows, configuring system enhancements, supporting testing and implementation, and identifying opportunities to improve efficiency, scalability, and performance.

Key Responsibilities Include:

• Lead and support business transformation, system configuration, and payment integrity initiatives across the claims administration platform and related systems.
• Partner with business stakeholders to understand needs, identify opportunities, and translate requirements into scalable system solutions.
• Configure and implement routine and project-related changes within the claims management platform.
• Analyze downstream impacts of system and process changes and develop clear requirements, workflows, use cases, process flows, and test cases.
• Develop and execute testing plans and support successful implementation of system enhancements.
• Facilitate collaboration among business users, IT teams, vendors, and project managers to ensure successful delivery.
• Support initiatives focused on payment integrity, cost savings, process improvement, and operational efficiency.
• Maintain system documentation, change requests, workflows, procedures, and supporting evidence.
• Design and maintain system reference tables and controls supporting areas such as provider, membership, benefits, pricing, medical management, claims, and finance.
• Support configuration and maintenance of correspondence generation, liability recovery, coordination of benefits, and related claims functions.
• Analyze data and system performance to identify opportunities for continuous improvement and make data-driven recommendations.
• Serve as a subject matter expert and solution champion, providing guidance and troubleshooting support to business partners and other departments.
• Collaborate with Project Managers and business leaders to evaluate current system capabilities and identify opportunities for transformation and optimization.

SCHEDULE:

• Full-time
• Hybrid work opportunity- candidate must live in MA or CT
• Requires at least 3 days a week on-site, more frequent during training
• Some weekends required

LOCATION:

• 1 Monarch Place
• Springfield, MA

QUALIFICATIONS:

• Associate's degree and 3 years of related experience, or an equivalent combination of education and experience.
• At least 3 years of related experience.
• Experience within health insurance, healthcare providers, or healthcare technology/vendors.
• Experience with Amisys and surrounding/supporting platforms is preferred, or experience configuring another claims adjudication platform.
• Knowledge of Medicare and Medicaid rules and regulations.
• Understanding of procedure and diagnosis codes and their relationship to claims adjudication and proper coding.
• Strong analytical and data-driven problem-solving skills.
• Demonstrated process improvement mindset with the ability to identify opportunities for greater efficiency and effectiveness.
• Strong communication, facilitation, and relationship-building skills.
• Project management experience and the ability to successfully manage multiple priorities.

Education:
Bachelors Degree (Required)

Certifications:

Compensation

Note: The compensation range(s) in the table below represent the base salaries for all positions at a given grade across the health system. Typically, a new hire can expect a starting salary somewhere in the lower part of the range. Actual salaries may vary by position and will be determined based on the candidate's relevant experience. No employee will be paid below the minimum of the range. Pay ranges are listed as hourly for non-exempt employees and based on assumed full time commitment for exempt employees.

Minimum - Midpoint - Maximum
$83,054.00 - $95,472.00 - $112,923.00