TPA core services Senior Business Analyst

About This Opportunity

We are representing a confidential federal healthcare organization supporting a critical mission that serves 9/11 responders and survivors. Our talent team is seeking a Senior Business Analyst to lead requirements alignment and operational excellence for Third Party Administrator (TPA) core services including eligibility, claims processing, provider data management, and member services.

This is a remote position based in the United States. The role requires a Moderate Background Investigation (T2) clearance and U.S. citizenship.

Responsibilities

• Lead requirements analysis, workflow documentation, and operational alignment activities across TPA core service components to ensure accurate and compliant healthcare delivery
• Collaborate with cross-functional technical teams, operational leads, QA testers, system vendors, data specialists, and government stakeholders to achieve seamless integration and system readiness
• Validate system logic and coordinate cross-system interoperability to ensure eligibility and claims systems operate correctly and consistently
• Drive process and requirements traceability end-to-end, resolving defects and ensuring functional correctness
• Utilize requirements management tools and integration analysis methods to support operational reliability
• Ensure compliance with HIPAA, PHI/PII security standards, and federal healthcare program requirements

What We're Looking For

• Education: Bachelor's degree required
• Experience: 5+ years in healthcare, payer operations, systems analysis, or federal program support
• Technical Skills: Requirements management, workflow/process modeling, EDI analysis, cross-system integration validation, proficiency with Jira/Confluence/Azure DevOps, understanding of eligibility and claims systems
• Domain Knowledge: Experience validating system and process outputs; familiarity with HIPAA compliance and federal healthcare program requirements
• Collaboration: Proven ability to coordinate across technical and operational teams
• Clearance: Ability to obtain Moderate Background Investigation (T2) clearance
• Citizenship: U.S. citizenship required
• Travel: Up to 10% as needed

How We Work With You

Candidates apply directly through Get A Job.ai. Our recruiting team will conduct an initial screening to understand your background and ensure alignment with the role requirements. Qualified candidates will then be submitted to our client for consideration. Please do not contact the client organization directly—all communication and coordination will be managed through our team to ensure a professional and streamlined process.

Pay

The salary range for this position is $97,750 - $132,250, set based on experience, geographic location, and program requirements. Our client offers comprehensive benefits including medical, dental, and vision coverage, 401(k) with company match, flexible work arrangements, paid time off, and professional development opportunities.

Equal Opportunity: Get A Job.ai is committed to providing equal employment opportunities to all applicants regardless of race, color, religion, sex, national origin, age, disability, veteran status, or any other protected characteristic under applicable law.