Business Systems Analyst, Sr.
About the Company
Sentara Health is a leading healthcare organization dedicated to providing high-quality, accessible, and innovative health services to communities across the United States. With a commitment to improving health every day, Sentara emphasizes patient-centered care, technological advancement, and community engagement. The organization boasts a diverse workforce of nearly 30,000 members, reflecting a culture of inclusion, collaboration, and continuous improvement. Sentara offers a comprehensive range of health services, including hospitals, outpatient care, health plans, and wellness programs, striving to meet the evolving needs of its patients and members.
About the Role
The Senior Business System Analyst at Sentara plays a pivotal role in supporting, enhancing, and implementing software applications critical to the organization’s operations. This fully remote position involves overseeing intermediate-scale projects or components of larger initiatives, developing detailed project plans, and coordinating resources to ensure successful delivery. The analyst will serve as a key liaison between business units, IT teams, and external partners, particularly focusing on Enrollment and Eligibility processes, including EDI 834 file exchanges. The role requires a strategic thinker capable of analyzing complex data flows, business processes, and system interfaces, especially related to enrollment and eligibility functions. The incumbent will identify opportunities to leverage technology for operational improvements, design application enhancements, and ensure compliance with industry standards and regulations. This position demands a proactive approach to troubleshooting, testing, and optimizing enrollment systems, with a focus on data accuracy, process efficiency, and customer satisfaction.
Qualifications
Bachelor’s degree in Computer Science, Business, Information Systems, Finance, Engineering, or related field (or equivalent experience) Minimum of 4 years of relevant experience in business analysis or related roles Proficiency in SQL, HTML, and CSS (preferred) Experience working with SQL for data analysis and troubleshooting Understanding of Software Development Life Cycle (SDLC) methodologies such as Agile, Waterfall Experience with EDI transactions, particularly EDI 834, is highly desirable Familiarity with healthcare systems like Salesforce, QNXT, Edifecs (preferred) Excellent communication and stakeholder management skills Ability to analyze complex data, develop detailed documentation, and support testing activities
Responsibilities
Serve as the primary liaison between business units, IT teams, and external partners regarding Enrollment and Eligibility processes, with a focus on EDI 834 file exchanges Elicit detailed requirements from stakeholders for onboarding and maintaining EDI 834 transactions Analyze, map, and document data flows, business processes, and system interfaces, especially for enrollment and eligibility functions Review and validate inbound and outbound EDI 834 files to ensure data integrity and compliance with industry standards Utilize project management methodologies such as Agile, Waterfall, and SDLC to support enrollment and eligibility projects Develop and execute SQL queries for data analysis, troubleshooting, and reporting related to enrollment data and EDI transactions Identify and mitigate operational and technological risks associated with enrollment file exchanges Lead testing, troubleshooting, and enhancement activities for enrollment systems and EDI integrations Build and maintain strong relationships with internal teams and external partners, including plan sponsors and TPAs Proactively identify opportunities for process improvements and technological innovations within enrollment and eligibility operations Drive initiatives aimed at increasing customer satisfaction by streamlining processes and enhancing data quality Evaluate project team performance to ensure objectives, timelines, and quality standards are met Oversee the design and implementation of new enrollment solutions and assess their operational impact Create and distribute monthly performance and operational reports using Tableau, Excel, and other analytics tools Stay informed of regulatory changes and industry trends related to EDI 834, HIPAA, and member enrollment Provide training and guidance to junior analysts and business units on EDI standards and enrollment best practices
Benefits
Comprehensive medical, dental, and vision insurance plans Adoption, fertility, and surrogacy reimbursement up to $10,000 Paid time off, sick leave, and paid parental and family caregiver leave Emergency backup care services Long-term and short-term disability insurance, critical illness plans Life insurance coverage 401(k)/403(b) retirement plans with employer match Tuition assistance up to $5,250 annually and access to discounted educational programs through Guild Education Student debt repayment assistance of up to $10,000 Pet insurance and legal resources plans Opportunity to earn annual discretionary bonuses based on system performance and eligibility Equal Opportunity Sentara Health is an equal opportunity employer committed to fostering a diverse and inclusive workforce. We value and promote diversity, equity, and belonging within our organization, ensuring that all employees and applicants are treated with fairness and respect. We encourage individuals of all backgrounds to apply and participate in our inclusive culture. Sentara Health is dedicated to creating a workplace free from discrimination and harassment, reflecting the communities we serve. We support our mission to improve health every day through a commitment to equity and diversity in all aspects of our organization.