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Job Requirements of Medicare Business Systems Analyst:
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Employment Type:
Contractor
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Location:
Grand Rapids, MI (Onsite)
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Medicare Business Systems Analyst
Job Title
Medicare Business Systems Analyst
Location
100% Remote
Expenses
No expenses allowed.
Equipment
Health equipment will be provided by the client.
Job Overview
The client is a Medicare Advantage (MAPD) health plan currently undergoing a major system migration from TriZetto Facets to Epic Tapestry, planned to go live on August 1, 2026.
They are looking for an experienced Business Systems Analyst (Contract) to temporarily replace a team member on maternity leave and support critical projects during the system migration and Annual Enrollment Period (AEP).
The analyst will work closely with business teams, IT teams, and vendors to ensure system requirements, testing, and operational processes run smoothly during this transition.
Key Responsibilities
Business Analysis & Requirements
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Gather and document business and technical requirements.
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Work closely with developers and technical teams to clarify requirements.
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Translate business needs into functional specifications for development teams.
Medicare Operations Support
Support processes related to:
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Medicare enrollment & eligibility
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Premium billing and payment processing
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Member fulfillment (ANOC, EOC, Formularies, Member Letters, etc.)
Testing & Quality Assurance
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Create and execute test cases and test scenarios
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Support Functional Testing, Integration Testing, and UAT
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Track and document defects and resolutions
Project & Agile Work
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Manage work in JIRA (user stories, backlog, defects, sprint tracking)
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Participate in Agile ceremonies
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Standups
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Sprint planning
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Backlog grooming
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Retrospectives
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Documentation
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Create process flows and workflow diagrams in Visio
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Document current state and future state processes
System Migration Support
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Assist with gap analysis
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Support system conversion activities
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Help ensure operational readiness before go-live
Risk Management
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Identify risks, issues, and dependencies related to migration and AEP timelines.
Required Qualifications
Candidates must have:
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5+ years of experience as a Business Analyst / Business Systems Analyst
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Experience working with Medicare Advantage (MAPD) health plans
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Strong experience with:
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Test case creation and UAT support
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JIRA (user stories, backlog, defects)
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Agile environments
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Visio for process documentation
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Strong knowledge of Medicare operations, including:
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Enrollment & Eligibility
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Premium Billing & Payments
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Member Fulfillment
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Experience collaborating with developers and technical teams
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Strong analytical, documentation, and communication skills
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Ability to work independently in a complex healthcare environment
Preferred (Nice to Have)
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Experience with Epic Tapestry
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Experience with TriZetto Facets / EAM / TCS
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Experience in system migrations or large platform conversions
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Knowledge of CMS regulations
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Experience supporting Annual Enrollment Period (AEP)