Job Title: Health Plan Implementation Business Analyst Location: 100% Remote Type: Contract-to-hire Duration: 6 months Rate: 62.50/hr Position 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 Qualifications
Bachelor’s degree in Business, Healthcare, IT, or related field
5+ years of experience as a Business Analyst in health plan environments
TPA (third-party administrator) experience a MUST
Strong knowledge of:
Eligibility and enrollment processes
File formats and EDI transactions (834, 837, 835)
Contribution accounting and financial allocation
Claims administration workflows
Experience with self-funded/self-insured and multiemployer plans
Hands-on experience with system integrations and data mapping
Strong documentation, analytical, and communication skills
Preferred Qualifications
Experience with leading TPA or payer platforms (e.g., Facets, QNXT, HealthRules)
Knowledge of medical management systems and workflows
Experience working with external vendors and third-party integrations
Familiarity with HIPAA and regulatory requirements
Key Competencies
Strong stakeholder management and client-facing skills
Ability to manage multiple implementations simultaneously
Detail-oriented with strong data validation skills
Problem-solving and critical thinking mindset
Ability to bridge business and technical teams
Nice-to-Have
Experience with Taft-Hartley / union-based plans
Exposure to stop-loss insurance integrations
Experience in consulting or client delivery environments
