System Analyst III

Job Summary

The System Analyst III is responsible for bridging the gap between business needs and Information Technology (IT) solutions in the Health Plan Payer environment. This position ensures that business intent is clearly captured, documented, and translated into technical implementation. The Analyst will support solution design, validation, and delivery for operational enhancements, compliance mandates, and system modernization initiatives. This position requires collaboration across cross-functional teams to ensure solutions are effective, compliant, and aligned with enterprise strategy. Acts as a Subject Matter Expert (SME), serves as a resource and mentor for other staff.

Duties

Collaborate with business stakeholders to gather and analyze requirements. 

Translate business needs into functional and technical specifications. 

Partner with internal teams to ensure accurate solution delivery. 

Support User Acceptance Testing (UAT) and production issue analysis by identifying root causes and corrective actions. Perform advanced system testing and validate data accuracy.

Document technical requirements, business workflows, data mappings, standard operating procedures, and integration points. Lead complex end-to-end business and technical analysis for workflows and enterprise applications.

Ensure compliance with Protected Health Information (PHI)/ Personally Identifiable Information (PII) handling, Health Insurance Portability and Accountability Act (HIPAA), and healthcare data security standards.

Ensure alignment with Agile delivery frameworks and Continuous Integration and Continuous Delivery (CI/CD) practices. 

Provide subject matter expertise on Health Plan systems and processes. Monitor and troubleshoot complex system issues and coordinate resolution.

Support staff by assisting with troubleshooting difficult issues related to deployment.

Evaluate and recommend system enhancements, configurations, integrations, and data flows to improve operational performance.

Apply subject matter expertise in evaluating business operations and processes. Identify areas where technical solutions would improve business performance. Consult across business operations, provide mentorship, and contribute specialized knowledge. Ensure that the facts and details are correct so that the program's deliverable meets the needs of the department, organization and legislation's policies, standards, and best practices. Provide training and recommend process improvements as needed.

Perform other duties as assigned.

Duties Continued

Education Required

Education Preferred

Experience

Required:

At least 4 years of experience as a System Analyst, Business Analyst, or Quality Assurance Engineer. 

Preferred:

Experience with claims, enrollment, or provider systems. 

Skills

Required:

Excellent analytical, problem-solving, and documentation skills.

Proficient in Agile methodology.

Excellent verbal, written communication and presentation skills.

Strong understanding of data mapping and data quality.

Ability to create process diagrams, data flows, and technical documentation.

Ability to manage multiple priorities in a fast-paced environment.

Preferred:

Knowledge in SQL, Jira, Confluence, and healthcare compliance.

Licenses/Certifications Required

Licenses/Certifications Preferred

Required Training

Required:

Training in Agile/Scrum and system analysis best practices.

Physical Requirements

Additional Information

Required:

May require occasional after-hours support during major deployments or incidents.