Tria Federal

Tria Federal, founded in 2023, is a technology and advisory services firm specializing in digital transformation solutions for the federal sector. Guided by its commitment to servi

Senior Business Analyst - Health Insurance Policy SME

Location

United States

Posted

4 days ago

Salary

0

Seniority

Senior

No structured requirement data.

Job Description

Senior Business Analyst - Health Insurance Policy SME

Tria Federal

Role Description Softrams is seeking a Senior Business Analyst/Health Insurance Policy SME with strong domain expertise in Medicare program knowledge, including understanding of Medicare Advantage (Part C) and Prescription Drug (Part D) programs, policies and data. The candidate will also possess knowledge of the prescription drug and pharmacy industry, including familiarity with established Electronic Data Interchange (EDI) standards, pharmacy data infrastructure, and drug coding conventions. The individual will be responsible for requirements analysis, legislative interpretation, and stakeholder engagement. The Senior Business Analyst/Health Insurance Policy SME works with the team to prioritize policy changes and features and build software products. This role is part of a collaborative and agile team that supports and builds modern, usable, and responsive applications for mission-critical health IT solutions. This is a 100% remote employment opportunity. All remote work must be performed in the United States. Qualifications - Demonstrated abilities to analyze complex business processes and operations. - Ability to represent user needs as user story requirements. - Ability to identify gaps and propose improvements. - Demonstrated ability to exercise creative and critical thinking. - Excellent oral and written communication skills. - Experience working with public facing civic tech projects. - Experience with Scaled Agile Framework (SAFe). - Agile certifications relevant to product owner and product analyst roles (e.g., PMI-ACP, CPM, CPO, CSM, PSM, SAFe POPM). - Ability to perform business process modeling and develop business process flows and concepts of operation for complex systems. Requirements - Ability to successfully obtain a U.S. Federal Position of Trust clearance designation. - Must reside in and be able to perform work in the United States. - Must have lived in the United States for 3 of the last 5 years. - A bachelor’s degree is required. - 8+ years of experience in working in software agile delivery with sprint teams. - 5+ years of total experience as a business analyst, product analyst, or product owner. - 3+ years of experience with healthcare IT programs including working on Medicare Advantage and Prescription Drug programs. Responsibilities - Work with dynamic and multi-functional teams to help develop and/or enhance products on a day-to-day basis. - Follow an Agile methodology while performing in a highly collaborative environment. - Be an expert in the client’s regulations, policies, and systems. - Work with the Product Owner and Product Manager, designers, the customer, users, and other stakeholders to capture product requirements as user stories. - Conduct policy analysis toward developing and adapting business requirements. - Conduct product analysis sessions, work group calls, user research, and usability testing. - Work with sprint team to implement and accept user stories as defined. - Work with the customer to develop agile documentation and oversee quality assurance activities. - Develop Change Requests following change control policies and procedures. Benefits - Top-tier benefits package to invest in your physical, mental, and financial health and wellness. - Opportunities to learn new skills and seize new challenges. - Commitment to fostering a culture of inclusion and opportunity for all.

Related Categories

Related Job Pages

More Business Analyst Jobs

Business Analyst

SAIC

SAIC® is a premier mission integrator focused on advancing the power of technology and innovation to serve and protect our world. Our robust portfolio of offerings across the defense, space, intelligence, and civilian markets includes secure high-end solutions in mission IT, enterprise IT, engineering services, and professional services. We integrate emerging technology, rapidly and securely, into mission critical operations that modernize and enable critical national imperatives. We are approximately 23,000 strong; driven by mission, united by purpose, and inspired by opportunities. SAIC is an Equal Opportunity Employer. Headquartered in Reston, Virginia, SAIC has annual revenues of approximately $7.3 billion. For more information, visit saic.com . For ongoing news, please visit our newsroom .

Role Description The Business Analyst will be responsible for developing, implementing, and maintaining an end-to-end approval workflow in Knowledge Services Network (KSN) to support the submission, review, approval, and tracking of travel requests. This effort will require close coordination with the project lead, contracting program, and technical stakeholders to ensure the solution aligns with applicable policies and operational requirements. - Analyze current travel request processes and identify gaps and improvement opportunities. - Design and develop a travel request approval workflow within KSN. - Configure forms, workflows, and approval routing in KSN. - Ensure compliance with applicable travel policies and approval authorities. - Coordinate with stakeholders to review designs, conduct testing, and support user acceptance. - Develop process documentation and provide training to users. - Support deployment and post-implementation refinements. General responsibilities are: - Analyzes business objectives and develops solutions to solve business issues. - Develops logical data models, analyzes and defines processes of business both “To Be” and “As Is.” - Identifies, analyzes, and documents business requirements and delivers work products throughout the project life cycle. - Analyzes the entire business, including data, goals, process, and organization and assists in developing strategic goals. - Uses process improvement, reengineering methodologies, and internet-related methodologies and principles to conduct process modernization projects. - Responsible for transitioning of existing organizations or project teams in accomplishing the organization's goals or project activities and objectives through improved use of internet and other automated processes. - Supports activity and data modeling, development of modern business methods, identification of best practices, and creating and assessing performance measurements. - Provides group facilitation, interviewing, training and additional forms of knowledge transfer. - Key coordinator between customers and multiple project teams to ensure enterprise-wide integration of reengineering efforts and application of best practice including e-business practices experience. Company Description SAIC® is a premier mission integrator focused on advancing the power of technology and innovation to serve and protect our world. Our robust portfolio of offerings across the defense, space, intelligence, and civilian markets includes secure high-end solutions in mission IT, enterprise IT, engineering services, and professional services. We integrate emerging technology, rapidly and securely, into mission critical operations that modernize and enable critical national imperatives. - We are approximately 23,000 strong; driven by mission, united by purpose, and inspired by opportunities. - SAIC is an Equal Opportunity Employer. - Headquartered in Reston, Virginia, SAIC has annual revenues of approximately $7.3 billion. - For more information, visit saic.com . - For ongoing news, please visit our newsroom .

United States
Qualia logo

Senior GTM Analyst

Qualia

Qualia is a software company self-described as "the leading" digital closing platform used by real estate professionals, homebuyers, and lenders to process real estate transactions

Role Description Ready to play an essential part in one of Qualia’s most exciting growth stages? In this role, you will join Qualia's Revenue Operations team as part of Platform Intelligence, the group that owns the systems and data that power our go-to-market motion. You'll administer Salesforce alongside our GTM Systems Lead and partner closely with GTM Engineering. You’ll work alongside the Ops Analysts, the interface to the GTM teams, to ensure each implementation is technically sound and serves the wider org. That work reaches you as scoped projects, where they've designed the workflow and you deliver it in Salesforce, and as incidental requests, the steady stream of smaller fixes a 250+ user org needs. Beyond the queue, you keep the org healthy: clearing bloat and clutter, resolving error alerts, and heading off quiet decay before it becomes the next problem. You use LLMs and AI-assisted tooling day to day to move faster on the analytical parts of admin work, and you help keep the org clean and well-structured so it's ready for AI-assisted ways of working. Responsibilities - Salesforce Administration: Own configuration and build across Sales, Service, and related clouds, including flows, validation rules, page layouts, record types, roles, profiles, permission sets, and sharing rules. Maintain a healthy, scalable org as pricing, packaging, and process complexity grow. - Build Delivery & Intake: Work the Case and Project queue alongside GTM Systems Lead. Take projects from scoping consult through sandbox build, UAT support, production launch, and post-launch stabilization, owning the technical design and reliability of what you ship. - Stakeholder Partnership: Serve as the implementation partner for RevOps analysts across Customer Success, Sales, Support, and Marketing. Share knowledge at Office Hours, lead implementation discussions, surface trade-offs and downstream impacts early, and turn workflow designs into Salesforce solutions that hold up in practice. - Documentation & Institutional Knowledge: Treat documentation as part of the deliverable, not an afterthought. Maintain runbooks, configuration notes, and change records so that system knowledge is institutional rather than living in one person's head. - Data Quality & System Health: Build with an eye for monitoring, diagnostics, and cleanup that catch issues before stakeholders do. Identify brittle assumptions, hardcoded dependencies, and accumulating risk, and propose the cleanup or redesign work to address them. - AI in the Workflow: Use LLMs and AI-assisted tools to accelerate investigation, documentation, requirement-gathering, and analysis. Help establish responsible patterns for where AI adds leverage to admin work and where human judgment stays in the loop. Qualifications - Salesforce Certified Administrator or Advanced Administrator (Required) - Experience with the broader RevOps tech stack (Zendesk, Totango/Gainsight, Gong, BigQuery or a similar data warehouse, BI/visualization tools) - Familiarity with Salesforce integration patterns (lookups, upserts, SOQL, deduplication strategies) and how data flows across connected systems - Light scripting or SQL for analysis and investigation Requirements - Operations Foundation: You started in Customer Success Operations or Sales Operations before moving into Salesforce administration, so you understand GTM processes and the people who depend on them from the inside. - Salesforce Craft: 3+ years configuring Salesforce (flows, validation rules, roles and profiles, permission sets, record types, reports and dashboards) with demonstrated proficiency. You can architect a solution, not just execute within an existing configuration. - Stakeholder Management: Strong interpersonal and communication skills with a track record of building credibility across an organization. You're comfortable scoping with business partners at all levels, you set expectations clearly, and you treat feedback and constructive challenge as a way to sharpen the solution. - AI Fluency: You actively use AI-assisted tools in your own workflow and are genuinely curious about where they help. You can distinguish tooling that accelerates the work from tooling that just adds noise. - Documentation Discipline: A pro-documentation mindset and real attention to naming conventions, configuration notes, and architectural decisions that favor long-term sustainability over short-term speed. - Systems Thinking: You think in systems, not tasks. You instinctively map how a change in one place affects teams downstream, and you know when to escalate and what trade-offs are worth making. - Comfort With Ambiguity: An owner's mentality and the ability to prioritize, context-switch, and drive work forward to meet the needs of a rapidly scaling organization. Benefits - Comprehensive health plans - 401k program - Commuter benefits - Professional development - Parental leave - Flexible time off policy - Robust online onboarding program - Biweekly all hands meetings - Variety of internal virtual events

United States

Role Description Every carrier CoverForce integrates with speaks its own dialect — its own industry codes, its own underwriting questions, its own appetite rules — and none of it lines up with anyone else's. This role exists to translate all of that carrier-specific chaos into one clean, standardized structure that our platform runs on, and to keep it accurate as carriers change their rules underneath us. This isn't a project-management or requirements-gathering role. You won't be writing tickets or managing a backlog. You'll be doing the actual data work: - Opening a carrier's raw underwriting sheet. - Figuring out what it means. - Turning it into something our system can use correctly. It's detailed, carrier-by-carrier work, and it rewards someone who gets faster at it over time by building tools and shortcuts rather than just grinding through the rows. What you'll do - Work against a few recurring problems, not a fixed checklist. - Build and hold mapping for industry and class codes across carriers. - Figure out underwriting logic from messy carrier-provided formats. - Onboard new carriers and update existing ones, treating them as the same problem. - Catch duplicates in underwriting questions flagged by a script. - Maintain a reliable way to know which carriers will write business for given criteria. - Provide fast, accurate answers on carrier, coverage, or data-quality questions. The single biggest lever in this role is automation. This work is naturally repetitive, and we want someone who treats that repetition as a problem to solve rather than a task to grind through — building scripts, spreadsheet tooling, or AI-assisted workflows, and pulling in engineering help or third-party tools where that's the faster path. Qualifications - Exceptional attention to detail. - A genuine drive to automate. - Real ownership of messy, inconsistent source files. - Proactive in asking questions for clarification. - A fast learner, able to pick up unfamiliar domains quickly. - Able to work remotely from India. Requirements - Experience in commercial P&C insurance (BOP, Workers' Comp, GL, Auto) is a plus. - Familiarity with NAICS, SIC, or NCCI coding systems. - Background as a business analyst, product analyst, or data/systems analyst. - Prior experience at a company integrating with multiple external partner APIs or carriers. - Python or other scripting experience. Benefits - Room for growth as carrier count increases. - Opportunity to build automation and own larger pieces of the pipeline. - Hands-on, detailed data work with potential for strategic involvement.

India
₹2,300K - ₹4,600K / year

Role Description Join one of the nation’s most comprehensive academic medical centers, UChicago Medicine, as a Business Ambulatory Analyst - Associate. This is a remote work from home opportunity and you may be based outside of the greater Chicagoland area. - Under direct supervision, assists in formulating and defining systems scope and objectives through research and fact-finding combined with a basic understanding of business applications and industry requirements. - Includes analysis of business and user needs, documenting requirements, and revising existing application configuration as necessary. - Collaborates with other members of the Application team. - Ability to consider most business implications of the application of technology to the current business environment. Essential Job Functions - Evaluate most business implications of technology in the current business environment. - Analyze business and user needs and assist in formulating and defining systems scope and objectives. - Document Requirements in the BRD (Business Requirement Document). - Revising existing (problematic) system logic or builds new application configurations. - Unit test configuration and other application set up. Qualifications - General understanding of information systems concepts and terminology. - Ability to cope in a fast-paced environment. - Capable of working well in a diverse, multi-disciplinary team. - High School degree or equivalent relevant certification in healthcare, business management or information systems is required. Requirements - Practical experience in a specific area of healthcare operations, Healthcare research or Healthcare teaching desired. - Associates degree or equivalent relevant certification in healthcare, business management or information systems. Position Details - Job Type / FTE: Full - Time - Shift: Days - Job Location: Remote - Unit/Department: Pharmacy Services Informatics - CBA Code: Non-Union Benefits UChicago Medicine is committed to transparency in compensation and benefits. The pay range provided reflects the anticipated wage or salary reasonably expected to be offered for the position. - The pay range is based on a full-time equivalent (1.0 FTE) and is reflective of current market data, reviewed on an annual basis. - Compensation offered at the time of hire will vary based on candidate qualifications and experience and organizational considerations, such as internal equity. - Pay ranges for employees subject to Collective Bargaining Agreements are negotiated by the medical center and their respective union.

United States
$68.8K - $80.2K / year