Health Insurance Business Systems Analyst

About this role

We are seeking a Healthcare Business Systems Analyst (BSA) to act as the primary bridge between business operations and technical teams. In this role, you will lead the digital integration of a new ecosystem by aligning Salesforce Health Cloud with core administration and automation platforms, specifically TriZetto QNXT and JET Insure (JET Health Solutions). You will gather requirements, design detailed data maps, and optimize end-to-end workflows from quoting to enrollment.

Job Overview

• **Position Title**: Health Insurance Business Systems Analyst
• **Employment Type**: Full-Time (strongly preferred)
• **Location**: Remote (must reside in US)

Key Responsibilities

Requirements Elicitation & Process Mapping

• Partner with payer-side operational stakeholders to discover and document business and technical requirements.
• Translate complex needs into actionable agile artifacts, including **epics, user stories, acceptance criteria, and process flows**.
• Map user journeys spanning front-end patient engagement in Salesforce to back-end quoting in **JET Insure** and claims processing in **QNXT**.

System Integration & Data Mapping

• Define integration requirements and data dictionaries connecting Salesforce Health Cloud objects with **QNXT database tables** (e.g., Member, Provider, and Claim tables).
• Manage data flows supporting the "quote-to-card" lifecycle using **JET Health Solutions**, ensuring seamless sync of benefit selections and enrollment data.
• Assist technical teams in verifying APIs, middleware gateways, and healthcare standard transactions.

System Configuration & Validation

• Validate **QNXT benefit plan configurations** (copays, deductibles, and adjudication rules) against business requirements.
• Leverage basic Salesforce configuration (Flows, Page Layouts) to build mockups and optimize care coordination templates inside Health Cloud.
• Write and execute structured **SQL and SOQL queries** to validate data integrity, troublesho...