Business System Analyst

Position Summary:

We are seeking a detail-oriented and analytical Mid-Level Facets Business Analyst to join our dynamic team supporting a major Blue Cross Blue Shield client. The successful candidate will act as a crucial bridge between our business stakeholders and technical development teams, translating complex business needs into clear and actionable system requirements. This role requires a deep conceptual understanding of the Facets platform and its core configuration, enabling the analyst to perform effective gap analysis, validate solutions, and ensure project success without hands-on system access.

Job Requirements

Required Qualifications:

· Education: Bachelor's degree in Business Administration, Information Systems, Healthcare Management, or a related field.

· Experience: -2-3 years of experience as a Business Systems Analyst in the healthcare insurance industry,

Facets Platform Knowledge: Demonstrated, extensive experience with the Facets platform.

• Candidate must possess a strong conceptual understanding of how the following core areas are configured and managed within Facets:
• · Member demographic data management
• · Member eligibility and enrollment logic
• · Product and benefit plan configuration
• · Claims processing, including eligibility-based adjudication and denial logic
• · Benefits, balances, and service limits
• · Prior authorization workflows and rules

· Analytical Skills: Proven ability to perform complex gap analysis, process modeling, and data analysis to support business decisions.

· Communication: Excellent verbal and written communication skills, with the ability to convey

technical concepts to non-technical audiences and business requirements to technical teams.

· Documentation: Strong proficiency in creating clear, comprehensive business documentation, including functional specifications, user stories, and workflow diagrams.

Preferred Qualifications:

· Experience working in an Agile/Scrum development environment.

· Familiarity with standard BA tools such as JIRA, Confluence, Visio, or similar platforms.

· Certification in Business Analysis (e.g., CBAP, CCBA) is a plus.