Hybrid Health Plan Operations Business Analyst

at Physicians Health Plan of Northern Indiana (PHP)

• Job title: Health Plan Operations Business Analyst
• Job type: Full Time
• Experience level: Mid level, Senior
• Salary: Not specified
• Degree requirement: Bachelor's Degree
• Tech skills: SQL
• Location requirements: Hybrid, Fort Wayne, United States

About the role

• Business Analyst supporting health plan operations at health insurance payer firm. Focus on QNXT system functionality, SQL-based reporting, and IT coordination in a hybrid work setup.

Responsibilities

• Support health plan operations with extensive experience in the health insurance payer space.
• Bridge the gap between business needs and technical solutions, ensuring data integrity and operational efficiency.
• Compile necessary medical fee schedules and load them into the QNXT adjudication system.
• Validate and audit new file transfers from digital services prior to implementation.
• Act as primary liaison between business users and project teams, documenting requirements.
• Participate in quality assurance and user acceptance testing.
• Analyze and optimize business processes within the QNXT system.

Requirements

• Bachelor’s degree in Business, Information Systems, Healthcare Administration, or related field.
• 3+ years of experience as a Business Analyst in a health plan or managed care environment.
• Strong hands-on experience with QNXT (TriZetto/Cognizant).
• Proficiency in SQL (T-SQL or PL/SQL) for data extraction, transformation, and reporting.
• Familiarity with EDI transactions (e.g., 837, 834, 835) and healthcare data standards.
• Experience working with IT interfaces, data integration, and troubleshooting.
• Excellent analytical, problem-solving, and communication skills.
• Ability to work independently and collaboratively in a fast-paced environment.

Benefits

• Health insurance
• Flexible work arrangements