Business Analyst (TPA - Healthcare / Benefits Administration)

Job Title: Business Analyst (TPA - Healthcare / Benefits Administration)

Location: [Remote / Hybrid / Onsite]
Type: [Contract / Full-time]

Position Overview

We are seeking a highly effective Business Analyst with experience in Third-Party Administration (TPA) to support business and operational initiatives within a healthcare payer environment.

This role requires someone who can confidently engage with business stakeholders, understand and map end-to-end business processes, and translate needs into clear, actionable requirements. The ideal candidate is articulate, process-driven, and able to bridge the gap between business and technology teams. Experience with SQL for data analysis is a strong plus.

Key Responsibilities
• Partner with business stakeholders to understand, document, and improve business processes across TPA functions
• Facilitate requirements gathering sessions, stakeholder interviews, and workshops
• Translate business needs into clear business and functional requirements (BRDs, FRDs, user stories)
• Analyze current-state and future-state processes and identify gaps and improvement opportunities
• Support initiatives across domains such as claims, eligibility, provider, customer care, and medical management
• Collaborate with IT, data teams, and vendors to ensure accurate implementation of requirements
• Create process documentation including process flows, use cases, and workflow diagrams
• Support UAT planning, execution, and validation of system and process changes
• Analyze data to validate business outcomes and support decision-making
• Communicate findings, requirements, and recommendations clearly to both technical and non-technical audiences
Required Qualifications
• 3+ years of Business Analyst experience in TPA, healthcare payer, or health plan environments
• Strong understanding of healthcare business processes (claims, eligibility, provider, customer service, etc.)
• Proven experience gathering, documenting, and managing business requirements
• Excellent verbal and written communication skills (clear, professional English required)
• Ability to confidently speak with business stakeholders and translate needs into actionable solutions
• Strong analytical and problem-solving skills
• Experience working in cross-functional environments (business + IT)
Preferred Qualifications
• Experience writing SQL queries for data analysis, validation, and reporting
• Familiarity with reporting and visualization tools (Excel, Power BI, Tableau, etc.)
• Experience with healthcare systems, claims platforms, or benefits administration systems
• Experience working in Agile and/or Waterfall environments