Senior Business Analyst - Healthcare

About this role

Pinnacle Method Consulting's mission is to help job seekers reach their career peak by accessing top-tier opportunities. We are not a staffing firm or agency. Pinnacle Method does not hire for these roles—we systematically source and verify them from premier employers.


Employer Industry: Healthcare


Why Consider This Job Opportunity

• Competitive benefits and compensation package
• Opportunity for career advancement and growth within the organization
• Work independently in a remote environment
• Engage with various stakeholders and make a meaningful impact on compliance and operational processes
• Strong emphasis on analytical problem-solving and project implementation

What To Expect (Job Responsibilities)

• Develop and maintain requirement documents related to coverage, reimbursement, and system changes
• Monitor regulatory sources to ensure alignment with updates and changes
• Lead the development and management of requirement interpretation processes and committee structures
• Conduct analysis to identify root causes and assist in problem management related to state requirements
• Communicate requirement interpretations and changes to health plans and corporate functional areas

What Is Required (Qualifications)

• At least 4 years of experience in a managed care organization, health insurance, or a directly adjacent field, or equivalent combination of education and experience
• Knowledge of policy and government legislative review
• Strong analytical and problem-solving skills
• Proficiency in Office Product Suite, including Word, Excel, Outlook, and Teams
• Experience in a dynamic and autonomous work environment

How To Stand Out (Preferred Qualifications)

• Project implementation experience
• Knowledge of federal regulatory policy resources, including CMS and the Affordable Care Act
• Medical Coding certification

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