BSA w/Provider Credentialing

Remote Full-time
Location: Remote (Candidates must reside in PA, DE, or NJ)

Must Have: Experience with provider credentialing, data management, and health plan systems

The BSA will lead the analysis, design, and implementation of solutions related to provider credentialing, data management, and health plan systems. This role requires a deep understanding of provider credentialing processes, provider data management, and master data management (preferred), coupled with strong communication and stakeholder management skills.

The successful candidate will act as the key liaison between business stakeholders and technical teams, driving clarity in requirements, ensuring successful implementation of solutions, and providing updates to leadership.

Key Responsibilities:
• Partner with business stakeholders to document business needs, requirements, and process flows, focusing on provider credentialing and provider data management.
• Analyze and document schema/data for source-to-target mapping.
• Collaborate with technical teams to identify and implement solutions aligned with business requirements.
• Leverage tools for provider credentialing, contracting, and data management on Salesforce models.
• Drive automation opportunities to enhance efficiency and accuracy.
• Act as the Technical Product Owner for Agile projects, including backlog management and sprint planning.
• Lead and coordinate across multiple concurrent projects, ensuring timely delivery and alignment with stakeholder expectations.
• Develop and communicate clear and concise status updates, standards, and changes to key stakeholders, ensuring alignment and confidence in the process.
• Represent the team in cross-functional meetings, audits, and reviews.
• Develop and oversee test plans, ensuring the quality and reliability of new systems or enhancements.
• Validate solutions against business requirements, ensuring successful implementation.

Required Skills and Qualifications:

Education: Bachelor s Degree in Information Systems, Computer Science, or a related field is preferred.

Experience:
• 7+ years of experience in IT and healthcare/health insurance environments.
• Proven expertise in health plan systems, provider credentialing, and provider data management processes.
• Experience with master data management (preferred)
• Familiarity with Agile frameworks, including roles such as Technical Product Owner.

Skills:
• Strong analytical and problem-solving skills, with attention to detail.
• Excellent verbal and written communication skills, with the ability to simplify complex concepts for diverse audiences.
• Strong stakeholder management and collaboration skills.
• Proficiency in SQL for data validation and analysis.

Work Environment:

This position operates remotely, with occasional travel required for in-person meetings, training, or audits. Candidates must reside in Pennsylvania, Delaware, or New Jersey.

Preferred Attributes:
• Knowledge of Medicare, Medicaid, and other healthcare payer systems.
• Experience creating dashboards, reports, and visualizations to support decision-making.
• A proactive and adaptable mindset with the ability to lead projects independently.

Apply Now

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