Negotiable
Undetermined
Remote
Remote
Summary: The role of Business Analyst focuses on supporting Agentic IVR and Conversational AI initiatives within the US Health Insurance domain. The candidate will gather and document business requirements while collaborating with various stakeholders to ensure compliance with healthcare regulations. A strong background in payer operations and Agile methodologies is essential for success in this position. The role is contract-based and fully remote.
Key Responsibilities:
- Gather, analyze, and document business requirements for Agentic IVR and Conversational AI solutions.
- Work with business stakeholders to understand payer workflows and translate them into detailed business and functional requirements.
- Analyze healthcare business processes including Claims, Eligibility, Benefits, Prior Authorization, Referrals, Enrollment, Member Services, Billing, Pharmacy, ID Cards, and Cost Responsibility.
- Prepare Business Requirement Documents (BRDs), Functional Requirement Documents (FRDs), User Stories, Acceptance Criteria, and process flows.
- Collaborate with Product Owners, Developers, QA teams, and client SMEs throughout the project lifecycle.
- Support UAT, Pre-UAT, Go-Live activities, and post-production validation.
- Ensure business requirements comply with HIPAA regulations, PHI/PII masking, and healthcare compliance standards.
- Participate in Agile ceremonies and maintain project documentation using Jira and Confluence.
Key Skills:
- 5+ years of Business Analyst experience in the US Health Insurance domain.
- Strong understanding of payer operations, including Claims, Eligibility, Benefits, Prior Authorization, Enrollment, and Member Services.
- Experience supporting IVR, Contact Center, Conversational AI, or Voice AI initiatives.
- Knowledge of HIPAA, PHI/PII handling, and healthcare regulatory requirements.
- Experience creating BRDs, FRDs, User Stories, and Acceptance Criteria.
- Hands-on experience with Jira, Confluence, and Agile/Scrum methodologies.
- Experience supporting UAT, Go-Live, and enterprise application implementations.
- Excellent communication, analytical, and stakeholder management skills.
Salary (Rate): undetermined
City: undetermined
Country: undetermined
Working Arrangements: remote
IR35 Status: undetermined
Seniority Level: undetermined
Industry: IT
Hiring: Business Analyst Health Insurance (Agentic IVR / Agentic AI)
Location: Remote
Employment Type: Contract
We are seeking an experienced Business Analyst with a strong background in the US Health Insurance domain to support Agentic IVR and Conversational AI initiatives. The ideal candidate will have expertise in payer operations, business analysis, and Agile delivery while working closely with business and technology stakeholders.
Responsibilities
- Gather, analyze, and document business requirements for Agentic IVR and Conversational AI solutions.
- Work with business stakeholders to understand payer workflows and translate them into detailed business and functional requirements.
- Analyze healthcare business processes including Claims, Eligibility, Benefits, Prior Authorization, Referrals, Enrollment, Member Services, Billing, Pharmacy, ID Cards, and Cost Responsibility.
- Prepare Business Requirement Documents (BRDs), Functional Requirement Documents (FRDs), User Stories, Acceptance Criteria, and process flows.
- Collaborate with Product Owners, Developers, QA teams, and client SMEs throughout the project lifecycle.
- Support UAT, Pre-UAT, Go-Live activities, and post-production validation.
- Ensure business requirements comply with HIPAA regulations, PHI/PII masking, and healthcare compliance standards.
- Participate in Agile ceremonies and maintain project documentation using Jira and Confluence.
Required Qualifications
- 5+ years of Business Analyst experience in the US Health Insurance domain.
- Strong understanding of payer operations, including Claims, Eligibility, Benefits, Prior Authorization, Enrollment, and Member Services.
- Experience supporting IVR, Contact Center, Conversational AI, or Voice AI initiatives.
- Knowledge of HIPAA, PHI/PII handling, and healthcare regulatory requirements.
- Experience creating BRDs, FRDs, User Stories, and Acceptance Criteria.
- Hands-on experience with Jira, Confluence, and Agile/Scrum methodologies.
- Experience supporting UAT, Go-Live, and enterprise application implementations.
- Excellent communication, analytical, and stakeholder management skills.
Preferred Qualifications
- Experience with Agentic AI, Intelligent Virtual Assistants, or Contact Center modernization projects.
- Exposure to enterprise healthcare digital transformation initiatives.