Health Plan Business Analyst - Implementation

Job Title: BA - Implementation, Claims & Medical Mgmt Location: 100% Remote Type: Contract-to-hire Duration: 6 months Rate: 62.50/hrPosition Overview We are seeking an experienced Health Plan Implementation Business Analyst with strong Third-Party Administrator (TPA) experience to support new client onboarding and implementation initiatives. This role is responsible for gathering requirements, coordinating integrations, and ensuring accurate setup of eligibility, enrollment, contributions, and claims administration processes. The ideal candidate has deep knowledge of self-funded/self-insured and multiemployer health plans, along with experience working across multiple stakeholders, vendors, and systems during implementation cycles.Required QualificationsBachelor's degree in Business, Healthcare, IT, or related field5+ years of experience as a Business Analyst in health plan environmentsTPA (third-party administrator) experience a MUSTStrong knowledge of:Eligibility and enrollment processesFile formats and EDI transactions (834, 837, 835)Contribution accounting and financial allocationClaims administration workflowsExperience with self-funded/self-insured and multi-employer plansHands-on experience with system integrations and data mappingStrong documentation, analytical, and communication skillsPreferred QualificationsExperience with leading TPA or payer platforms (e.g., Facets, QNXT, HealthRules)Knowledge of medical management systems and workflowsExperience working with external vendors and third-party integrationsFamiliarity with HIPAA and regulatory requirementsKey CompetenciesStrong stakeholder management and client-facing skillsAbility to manage multiple implementations simultaneouslyDetail-oriented with strong data validation skillsProblem-solving and critical thinking mindsetAbility to bridge business and technical teamsNice-to-HaveExperience with Taft-Hartley / union-based plansExposure to stop-loss insurance integrationsExperience in consulting or client delivery environments