Sentara Health is a leading integrated healthcare organization dedicated to improving health and well-being in the communities it serves. With a strong commitment to excellence, innovation, and compassionate care, Sentara provides a comprehensive range of medical services, including hospitals, outpatient centers, and health plans. The organization prides itself on fostering a diverse and inclusive workforce that reflects the communities it serves. Sentara emphasizes continuous improvement, leveraging advanced technology and data-driven strategies to deliver high-quality healthcare solutions. As a mission-driven entity, Sentara aims to enhance the patient experience, improve health outcomes, and promote a culture of safety and accountability across all levels of its operations.
About The Role
Sentara Health is currently seeking a Senior Business System Analyst to join its dynamic team. This fully remote position offers an exciting opportunity for experienced professionals to contribute to the support, enhancement, and implementation of software applications critical to the organization’s operational success. The Senior Business System Analyst will oversee and coordinate intermediate-scale projects or segments of larger initiatives, develop detailed project plans, and manage resources effectively to meet organizational goals. The role involves working closely with various stakeholders, including business units, IT teams, external partners, and software vendors, to ensure that technology solutions align with operational needs and regulatory standards. The ideal candidate will possess strong analytical skills, project management expertise, and a deep understanding of healthcare enrollment and eligibility processes, particularly EDI 834 transactions.
Qualifications
The ideal candidate will possess a bachelor’s degree in a relevant field such as Computer Science, Business, Information Systems, or related disciplines. Candidates with over six years of relevant experience without a formal degree will also be considered. A minimum of four years of experience in a similar role is required, demonstrating proficiency in SQL and understanding of the Software Development Life Cycle (SDLC). Knowledge of healthcare-specific platforms such as Salesforce, QNXT, and Edifecs is preferred. Technical skills in HTML and CSS are advantageous. Candidates should have experience working with data analysis, process mapping, and system testing, with a strong ability to elicit and document requirements, develop test cases, and troubleshoot complex issues. Excellent communication, stakeholder management, and project coordination skills are essential for success in this role.
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 pertaining to enrollment and eligibility functions.
- Review and validate inbound and outbound EDI 834 files to ensure data accuracy, integrity, and compliance with industry standards and regulations.
- Manage projects using methodologies such as Agile, Waterfall, and SDLC to support enrollment and eligibility system enhancements.
- Develop and execute SQL queries to analyze data, troubleshoot issues, and support transaction processing.
- Identify operational and technological risks related to enrollment file exchanges and implement mitigation strategies.
- Lead testing, troubleshooting, and system enhancement activities for enrollment systems and EDI integrations.
- Build and maintain strong relationships with internal teams and external partners, including plan sponsors and third-party administrators.
- Proactively identify opportunities for process improvements and innovative solutions within enrollment and eligibility operations.
- Drive initiatives to improve customer satisfaction by streamlining EDI processes, increasing data accuracy, and optimizing workflows.
- Evaluate project team performance, ensuring that objectives, timelines, and targets are consistently achieved.
- Oversee the design, development, and implementation of new enrollment-related solutions, assessing their impact on operational efficiency and customer experience.
- Create and distribute monthly reports analyzing performance metrics and operational data using tools such as Tableau and Excel.
- Stay informed about regulatory changes and industry trends related to EDI 834, HIPAA, and member enrollment processes.
- Provide training and guidance to junior analysts and business units on EDI standards and enrollment best practices.
Sentara Health offers a comprehensive benefits package designed to support colleagues and their families. Benefits include medical, dental, and vision plans, as well as life and disability insurance. The organization provides paid time off, sick leave, and paid parental and family caregiver leave to promote work-life balance. Additional perks include emergency backup care, pet insurance, legal resources, and long-term and short-term disability coverage. Sentara also offers a robust 401(k)/403(b) retirement plan with employer matching contributions, along with tuition assistance up to $5,250 annually and student loan repayment programs. Colleagues have opportunities to earn discretionary bonuses based on system performance and individual contributions. The organization emphasizes career development and continuous learning, fostering an environment where colleagues can grow professionally while maintaining a healthy work-life balance.
Equal Opportunity
Sentara Health is an equal opportunity employer committed to fostering a diverse and inclusive workforce. The organization values the unique perspectives and experiences of all employees and is dedicated to providing a work environment free from discrimination and harassment. Sentara actively promotes diversity, equity, and inclusion initiatives to ensure that its workforce reflects the diverse communities it serves. All qualified applicants will receive consideration for employment regardless of race, color, religion, gender, sexual orientation, gender identity, age, disability, or veteran status. Sentara supports its mission "to improve health every day" through a culture of respect, belonging, and opportunity for all.