Business Engineer

Signature Advantage

We are seeking a skilled and detail-oriented Business Engineer to join our health plan team. The ideal candidate will oversee the configuration, testing, quality assurance, and reporting processes necessary to optimize the operational performance of our health plans. This role bridges the gap between business operations, technical teams, and quality control, ensuring that our health plan systems and processes align with organizational goals and regulatory requirements.

Configuration Management:

• Configure and maintain the health plan systems to support benefit structures, provider networks, eligibility, claims processing, and other operational needs.
• Collaborate with stakeholders to gather business requirements and translate them into technical specifications.
• Ensure timely implementation of plan updates, such as new benefit designs or regulatory changes.
• Testing and Quality Assurance:
  
  • Develop and execute test plans to validate system configuration, data integrity, and overall performance.
  • Identify and document system issues, working with technical teams to resolve defects and ensure compliance with requirements.
  • Perform regression testing to ensure that changes do not adversely affect existing configurations or processes.
• Reporting and Analytics:
  
  • Design and generate reports to monitor operational performance, member outcomes, and compliance metrics.
  • Analyze data to identify trends, anomalies, and opportunities for process improvement.
  • Collaborate with leadership to provide insights and recommendations based on reporting results.
• Process Optimization and Documentation:
  
  • Continuously review and refine business processes to improve efficiency and effectiveness.
  • Document all configurations, testing protocols, and quality assurance procedures to maintain clear operational records.
• Cross-Functional Collaboration:
  
  • Serve as a liaison between business operations, IT, and quality assurance teams to ensure seamless coordination and communication.
  • Participate in cross-functional projects, including system upgrades, new product launches, and regulatory audits.

• Bachelor's degree in Business Administration, Engineering, Computer Science, or equivalent work experience.
• Three to five years of experience in business analysis, system configuration, testing, or quality assurance in a health plan or healthcare environment.
• Familiarity with health plan operations, including benefits, claims, eligibility, and provider network management.
• Experience with Microsoft Azure Environment and/or Data Factory preferred.
• Strong analytical and problem-solving skills with attention to detail.
• Proficiency in system configuration and reporting tools (e.g., Facets, QNXT, SQL, Tableau, Power BI).
• Knowledge of healthcare regulations, such as HIPAA and ACA requirements.
• Excellent written and verbal communication skills.
• Ability to manage multiple priorities and meet tight deadlines.
• Travel up to 25%