Medicare/Medicaid- Business Analyst

Business Analyst with Medicare (Medicap).Location: Piscataway, NJ Hybrid 3 days a weekContractAbout the Role: Seasoned Senior Business Analyst with extensive expertise in theHealth/Medicare insurance domain, specifically Long-Term Care (LTC) insurance. The idealcandidate will possess a deep understanding of policy terms, claim adjudication processes,and US regulatory compliance. You will act as a bridge between business needs andtechnical teams, facilitating effective communication, requirements gathering, and solutiondelivery in an Agile environment. Your role will be crucial in optimizing LTCQualifications:Proven experience as a Business Analyst in the LTC Insurance TPA domain, with knowledgeof US regulations.Strong ability to interpret LTC policy language, claims adjudication processes, and regulatorycompliance.Expertise in Agile/Scrum methodologies with experience collaborating in cross-functionalteams.Excellent communication skills to effectively liaise with technical and non-technicalstakeholders.Strong analytical skills with proficiency in creating process maps, use cases, wireframes,and visual documentation.Experience supporting testing phases including system, integration, and UAT.Expertise in requirements traceability, change management, and stakeholder expectationmanagement.Analyze and interpret LTC insurance policy terms, benefits, claim adjudication guidelines,and US regulatory requirements.Conduct gap analysis to identify inefficiencies in LTC claims adjudication and benefitmanagement.Assist in designing, development, and validation of automated workflows for LTC claimsprocessing.Facilitate integration and testing of LTC claims systems and third-party vendor platforms.Support customization of LTC policy rules to align with client needs.Serve as the knowledge domain expert for training, documentation, and knowledge transfer.Elicit, analyze, and document comprehensive business, functional, and non-functionalrequirements related to LTC insurance.Develop process flow diagrams, use cases, wireframes, and visual aids for clearcommunication.Prepare and maintain requirement traceability matrices to ensure coverage and alignment.Act as a liaison between business stakeholders, product owners, and technical teams.Lead stakeholder interviews, workshops, and requirement sessions.