The Stefanini Group is a global provider of offshore, onshore and near shore outsourcing, IT digital consulting, systems integration, application, and strategic staffing services to Fortune 1000 enterprises around the world. Our presence is in countries like the Americas, Europe, Africa, and Asia. More than four hundred clients across a broad spectrum of markets, including financial services, manufacturing, telecommunications, chemical services, technology, public sector, and utilities. Stefanini is a CMM level 5, IT consulting company with a global presence.
Medicare Business Systems Analyst
Location
United States
Posted
3 days ago
Salary
Not specified
No structured requirement data.
Job Description
Role Description
Stefanini is looking for a Medicare Business Systems Analyst – 100% Remote. We are a large Medicare Advantage (MAPD) health plan undergoing a major core system transformation, migrating from TriZetto Facets to Epic Tapestry effective August 1, 2026. We are seeking an experienced Contract Business Systems Analyst to backfill a key team member during maternity leave and to support critical initiatives during system migration and Annual Enrollment Period (AEP) readiness.
This role will be embedded within our Medicare Business Systems Analyst team and will partner closely with business, IT, and vendor stakeholders to ensure continuity of operations, accurate requirements delivery, and successful testing and implementation during a high impact period.
- Serve as a Business Systems Analyst supporting Medicare Advantage operational processes during Epic Tapestry migration and AEP preparation
-
Elicit, analyze, and document business and technical requirements related to:
- Medicare enrollment and eligibility
- Premium billing and payment processing
- Member fulfillment (ANOC, EOC, Formularies, Member Letters, etc.)
- Translate business needs into clear functional and technical requirements for development teams
- Collaborate closely with developers and technical teams to clarify requirements, answer questions, and support solution design
- Create, maintain, and execute test cases and test scenarios to validate system changes and ensure business requirements are met
- Support functional testing, integration testing, and user acceptance testing (UAT); document defects and track resolution
- Manage and track work in JIRA, including user stories, acceptance criteria, assumptions, and status reporting
- Develop and maintain process flows and current/future state documentation using Visio
- Support system conversion activities including gap analysis, workflow changes, and operational readiness
- Participate in Agile ceremonies (daily stand ups, sprint planning, backlog refinement, retrospectives)
- Identify risks, issues, and dependencies related to migration and AEP timelines and escalate as appropriate
Qualifications
- 5+ years of experience as a Business Analyst or Business Systems Analyst in a MAPD Plan
- Strong experience writing, executing, and managing test cases and supporting UAT
- Demonstrates experience working with developers to provide technical and functional requirements
- Strong hands on experience working in JIRA (user stories, backlogs, sprint tracking, defect management)
- Experience creating process documentation and workflow diagrams using Visio
-
Solid understanding of Medicare Advantage operations, including:
- MAPD Enrollment and eligibility
- MAPD Premium billing and payment processing
- MAPD Member fulfillment processes
- Experience working in Agile delivery environments
- Strong analytical, documentation, and stakeholder communication skills
- Ability to operate independently and ramp up quickly in a complex, regulated healthcare environment
Requirements
- Experience with Epic Tapestry (payer platform)
- Prior experience supporting TriZetto Facets/EAM/TCS or similar core administration platforms
- Experience supporting system migrations or large scale system conversions
- Familiarity with CMS regulations impacting Medicare Advantage operations
- Prior experience supporting Annual Enrollment Period (AEP) activities or peak enrollment cycles
Benefits
- Listed salary ranges may vary based on experience, qualifications, and local market.
- Some positions may include bonuses or other incentives.
Job Requirements
- 5+ years of experience as a Business Analyst or Business Systems Analyst in a MAPD Plan
- Strong experience writing, executing, and managing test cases and supporting UAT
- Demonstrates experience working with developers to provide technical and functional requirements
- Strong hands on experience working in JIRA (user stories, backlogs, sprint tracking, defect management)
- Experience creating process documentation and workflow diagrams using Visio
- Solid understanding of Medicare Advantage operations, including: MAPD Enrollment and eligibility
- MAPD Premium billing and payment processing
- MAPD Member fulfillment processes
- Experience working in Agile delivery environments
- Strong analytical, documentation, and stakeholder communication skills
- Ability to operate independently and ramp up quickly in a complex, regulated healthcare environment
- Experience with Epic Tapestry (payer platform)
- Prior experience supporting TriZetto Facets/EAM/TCS or similar core administration platforms
- Experience supporting system migrations or large scale system conversions
- Familiarity with CMS regulations impacting Medicare Advantage operations
- Prior experience supporting Annual Enrollment Period (AEP) activities or peak enrollment cycles
Benefits
- Listed salary ranges may vary based on experience, qualifications, and local market.
- Some positions may include bonuses or other incentives.
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