System Analyst

<p><strong>Company:</strong> Confidential</p><p><strong>Industry:</strong> Healthcare / Health Insurance</p><p><strong>Location:</strong> Remote – Candidate must reside in Idaho, Utah, or North Dakota</p><p><strong>Work Schedule:</strong> Central Time Zone hours</p><p><strong>Employment Type:</strong> Contract / Full-Time/W2 Only.</p><p><br></p><p><strong>Overview</strong></p><p>We are seeking an experienced Senior Business Systems Analyst to support the operation, enhancement, configuration, testing, and continuous improvement of healthcare membership systems.</p><p>This role will work closely with business and technical teams to translate membership and enrollment requirements into functional system solutions, configurations, data requirements, testing strategies, and production-ready enhancements.</p><p>A major focus will be supporting Facets membership processing and healthcare enrollment data. Experience with Healthcare EDI, particularly ANSI X12 834 Enrollment and Maintenance transactions, is required.</p><p>The successful candidate will be comfortable working hands-on with system configuration, SQL analysis, requirements development, testing, data validation, production troubleshooting, and healthcare membership processes.</p><p><br></p><p><strong>Key Responsibilities:</strong></p><p><strong>Facets Membership & Enrollment</strong></p><ul><li>Support daily operations and enhancements within the Facets membership environment.</li><li>Analyze membership enrollment, maintenance, and disenrollment processes.</li><li>Understand how enrollment information moves through Facets, interfaces, EDI workflows, and downstream systems.</li><li>Investigate membership discrepancies, configuration issues, and data-processing problems.</li><li>Support X12 834 enrollment and maintenance transactions when applicable.</li></ul><p><strong>Business & Systems Analysis</strong></p><ul><li>Gather and analyze business requirements and translate them into clear functional requirements.</li><li>Define system configuration, data, interface, and processing requirements.</li><li>Review data flows, interface designs, logical data structures, conversion plans, and technical specifications.</li><li>Identify gaps or inconsistencies between business needs and proposed technical solutions.</li><li>Serve as a liaison between business users, developers, and technical teams.</li><li>Document requirements and acceptance criteria sufficiently to support development and testing.</li></ul><p><strong>Facets Configuration & Data Analysis</strong></p><ul><li>Configure assigned Facets functionality based on approved business requirements.</li><li>Use SQL to research membership data, investigate issues, validate system behavior, and support data solutions.</li><li>Develop SQL scripts, ad hoc reports, and supporting analysis as needed.</li><li>Analyze Facets tables, interfaces, and related data structures.</li><li>Support data conversion, migration, and validation activities.</li><li>Ensure data modifications follow approved change, security, backup, and implementation procedures.</li></ul><p><strong>Testing & Quality Assurance</strong></p><ul><li>Develop and execute functional, regression, integration, conversion, and post-implementation testing.</li><li>Define expected results and validate actual system outcomes.</li><li>Test membership processing, Facets configuration, interfaces, and EDI transactions.</li><li>Validate X12 834 enrollment and disenrollment scenarios when applicable.</li><li>Document defects, test results, remediation, and retesting.</li><li>Work with business and technical teams to resolve issues before production implementation.</li></ul><p><strong>Production Support</strong></p><ul><li>Investigate production issues involving Facets functionality, membership data, system configuration, interfaces, security, and EDI processing.</li><li>Use SQL, application analysis, transaction data, and root-cause investigation to identify the source of problems.</li><li>Determine whether issues originate from configuration, data, interfaces, or business processes.</li><li>Coordinate corrective action with business users, developers, and technical teams.</li><li>Identify recurring issues and recommend improvements that reduce future incidents.</li></ul><p><strong>Documentation & Process Improvement</strong></p><ul><li>Maintain documentation for system configurations, business requirements, data processes, test results, known issues, and implementation procedures.</li><li>Document membership processes, system dependencies, interfaces, and important data relationships.</li><li>Identify opportunities to improve requirements gathering, testing, troubleshooting, implementation, and ongoing system support.</li><li>Support knowledge transfer and continuous improvement across the team.</li></ul><p><br></p><p><strong>Required Experience</strong></p><ul><li>Experience as a Business Systems Analyst, Systems Analyst, or similar role within healthcare or health insurance.</li><li>Experience supporting healthcare membership, enrollment, claims, provider, or related health-plan systems.</li><li>Hands-on experience gathering and documenting business and functional requirements.</li><li>Experience with system configuration and functional solution design.</li><li>Practical SQL experience for data analysis, troubleshooting, and validation.</li><li>Experience developing and executing functional, regression, integration, and acceptance testing.</li><li>Experience investigating and resolving production system issues.</li><li>Strong understanding of data flows, interfaces, system dependencies, and business processes.</li><li>Ability to communicate effectively between business and technical stakeholders.</li><li>Strong analytical, problem-solving, and documentation skills.</li></ul><p><strong>Highly Preferred Experience</strong></p><ul><li>Facets membership processing</li><li>Facets configuration, tables, and data structures</li><li>Healthcare membership and enrollment operations</li><li>Healthcare EDI</li><li>ANSI X12 834 Enrollment and Maintenance transactions</li><li>Member enrollment, maintenance, and disenrollment processing</li><li>SQL-based Facets data analysis</li><li>Healthcare data conversion or migration</li><li>Health insurance or health-plan operations</li></ul><p><br></p><p><strong>Ideal Candidate</strong></p><p>The strongest candidate will combine healthcare business systems analysis experience with practical knowledge of Facets membership and enrollment processing.</p><p>Candidates should be able to investigate how enrollment data moves through healthcare systems, identify configuration or data issues, analyze information using SQL, translate business needs into functional solutions, and thoroughly test changes before production implementation.</p><p>Experience working with X12 834 transactions is particularly valuable for candidates who understand member enrollment, changes, terminations, and downstream membership processing.</p><p>Education & Experience</p><p>A degree in Computer Science, Mathematics, Business Administration, or a related discipline is preferred, although relevant healthcare industry experience may substitute for formal education.</p><p>Candidates should have experience defining and analyzing business requirements, functional systems design or configuration, testing, and supporting a healthcare business area such as membership, claims, or provider operations.</p>

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