Job Description

We are currently looking for a Business Analyst for a 100% remote position supporting a large federal government healthcare modernization project. The Business Analyst will drive the technical and functional integration of the Payment Integrity Validation and Oversight Tool (PIVOT) with Community Care Development, Security, and Operations (CCDSO) products and core systems such as CCRS. This role will connect federal healthcare reimbursement policies, high-volume claims processing, and automated validation frameworks to improve payment accuracy and prevent fraud, waste, and abuse across the Department of Veterans Affairs.

This role operates within a collaborative, cross-functional Agile and SAFe team environment and requires close coordination with Scrum teams, business stakeholders, technical teams, and the PIVOT contractor throughout the development lifecycle.

The candidate must reside within the continental US.

Responsibilities

• Lead requirements definition and backlog grooming for system-to-system integrations connecting PIVOT with CCDSO products and supporting VA financial and authorization data sources.
• Translate federal healthcare reimbursement rules and complex billing parameters into automated business logic, risk-scoring parameters, and rules-engine specifications.
• Analyze and map EDI transactions, including 837 and 835 claims data, healthcare interoperability standards such as HL7 and FHIR, and APIs connecting VA systems with modern analytics components.
• Collaborate with Scrum teams to analyze business requirements and translate them into actionable user stories, acceptance criteria, and clearly defined technical and functional requirements.
• Lead discovery sessions, requirements workshops, and stakeholder feedback loops while maintaining business cases, capability models, process flows, and decision logs.
• Oversee end-to-end validation activities, including UAT strategy, test planning, acceptance governance, compliance validation, and business-readiness assessments.
• Take on additional tasks and responsibilities as needed to support team objectives and ensure the success of the project.

Requirements

• Bachelor's degree in Computer Science, Information Systems, Business, or a related discipline and at least eight years of progressive Business Analyst experience.
• Significant experience supporting federal healthcare IT, claims-processing modernization, payment integrity, or Department of Veterans Affairs system integration initiatives.
• Demonstrated success working within Agile and SAFe environments, including PI planning, backlog refinement, cross-team dependency management, and portfolio operations.
• Demonstrated expertise analyzing, interpreting, mapping, and validating EDI transactions within complex enterprise claims-processing workflows.
• Hands-on experience mapping APIs, reviewing HL7 and FHIR data-exchange standards, and working with microservices, cloud-native architectures, enterprise systems, and software development lifecycles.
• Exceptional analytical, problem-solving, communication, documentation, stakeholder-management, and cross-functional collaboration skills.

Additional Qualifications

• Experience supporting VA Community Care, CCDSO, PIVOT, CCRS, or comparable federal healthcare payment-integrity platforms.
• Knowledge of healthcare reimbursement, claims adjudication, fraud, waste, and abuse detection, automated rules engines, and risk-scoring methodologies.
• Certified Business Analysis Professional, SAFe certification, PMI Professional in Business Analysis, or a comparable Agile or business-analysis certification.

Security Clearance Requirements

• U.S. Citizenship is required.
• All selected candidates must successfully complete a background check.
• Ability to obtain and maintain a Government/Public Trust clearance, including required fingerprinting, when required for the position.

Benefits

• Medical/Dental/Vision
• 401k with Employer Match
• PTO + Federal Holidays
• Corporate Laptop
• Training Opportunities
• Remote Opportunity

"VetsEZ is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability, or protected veteran status.

Sorry, we are unable to offer sponsorship at this time.

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