CareFirst Careers

Lead Healthcare Insurance Business/Requirements Analyst

Resp & Qualifications

The Lead Requirements Analyst duties and responsibilities include but are not limited to those identified in the following table:

Elicitation/Specification/Validation/Requirements Traceability: 
• Leads in requirements discovery to document the needs of customers and potential stakeholders. 
• Works closely with internal and external customers to ensure the root requirements are discovered. 
• Partners with business users to understand strategic goals as the subject matter expert to the customers needs as well as the systems functionalities. 
• Helps to elicit industry standard requirements using processes such as Joint Application Development (JAD), interviews, prototyping, and user observation. 
• Leads in the development of complete, unambiguous description of the solution using user stories, acceptance criteria, functional requirements, and business rules that are both verifiable and traceable.
• Translates business needs and functional requirements into technical requirements.  Communicates with the development and testing experts using highly complex and technical language. 
• Develops and manages the requirements traceability such as tracing across the software development lifecycle to ensure that each succinct requirement is met at each step of the lifecycle.  Additionally, traces up and down through the parent-child relationship within the requirements.
• Lead the requirements validations by working closely with internal and external customers to validate requirements against the needs of the customers. 
• Leads the creation of requirements repositories to store historical requirements information. 
• Uses tools such as JIRA to store requirements. 
• Performs business support responsibilities and consultation with internal and external customers and any other projects as requested in support of management. 
Analysis and Modeling: 
• Leads analysis of existing business process and systems. 
• Uses industry best practices and analytical techniques such as:
o State charts,
o Process modeling,
o Decision tree analysis,
o User stories with acceptance criteria (ideally in the Gherkin format)
o Functional and non-functional specifications
• Recommends process and system enhancements to improve business performance and maximize the effectiveness of available technology. 
• Creates and analyze requirement models to increase understanding and uncover potential issues.
• Conducts impact and gap analysis of systems and business process workflows. 
• Leads the building of a knowledge base of business information using various types of models. 
• Serves as a subject matter expert for business processes and related systems including analyzing and researching complex system problems, as well as coordinating with vendors and other parties as necessary.
• Support multiple internal and external stakeholders that use web, mainframe, and distributed systems technologies.
• Leads the process of defining, documenting, and maintaining editorial quality of:
o Business system requirements,
o User stories and acceptance criteria ,
o Business work papers, and
o Functional specifications/documentation
These documents will be shared with a broad internal and external audience. 
• Assists with providing Plans with customizable software product package.
• Expands knowledge and skills of existing and new business processes, quality assurance, and system development methodologies. 
• Expands knowledge of healthcare terminology and industry changes such as industry codes

Required Education: 

• Bachelor’s degree in Computer Science, Information Systems, or related field with 5-7 years of requirements management and requirements engineering, OR equivalent related analytical/healthcare insurance experience
Required Experience:
• Experience with software testing, test management and defect tracking tools.
• Prior extensive experience leading impact and gap analysis of systems and business process workflows as well as using various types of models and straw man prototypes.
• Prior extensive health insurance industry experience and knowledge within a cross functional environment. 
• Previous experience with a requirements tool such as JIRA or ALM
• Root cause analysis experience
• Proven experience accurately estimating requirements
• Expert knowledge of software development lifecycle methodology such as scrum, kanban, iterative and/or waterfall
• Expert knowledge of Microsoft® Office®
• Must be knowledgeable of multiple technologies such as web, mainframe, distributed systems, etc. to support multiple internal and external stakeholders that use those technologies  

Required Abilities/Skills:
• Ability to lead dynamic, energized, and highly creative multidiscipline high-performance work teams in learning and applying new skills/techniques to respond to business needs.
• Ability to effectively adapt to rapidly changing technology and apply it to business needs.
• Considerable experience managing and delivering Business and IT centric projects using (where appropriate) leading-edge technology, and older legacy systems. 
• Thorough knowledge and understanding of the company’s business practices and direction, business principles, and business processes, plus familiarity with the company’s products and resources.
• Solid teamwork and interpersonal skills, with the ability to communicate and persuade customers, employees, and management at all levels and thrive in a cross-functional environment. 
• Excellent oral and written communications; an ability to present and discuss technical information in a way that establishes rapport, persuades others, and gains understanding.
• Strong customer focus and dedication to customer service in a collaborative consulting model
• IT program management experience, effectively arranging resources and managing multiple small to large projects in a cross-functional environment.
• Ability to analyze project needs and determine resources needed to meet objectives.
• Ability to create original concepts and take heuristic approaches to testing/refining existing theories and to develop new system approaches to solve problems and seize opportunities to sustain business success. 
• Strong analytical, problem-solving, and conceptual skills.
• Hands-on health insurance claims processing experience and ability to demonstrate knowledge of underlying adjudication business concepts and logic. 
• Master’s degree in a related field
• Knowledge of organization, operations and business systems
• Experience with the implementation of a business rules engine and its use in a production environment


Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer.  It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Hire Range Disclaimer

Actual salary will be based on relevant job experience and work history.

Where To Apply

Please visit our website to apply:

Closing Date

Please apply before: 10/9/2020

Federal Disc/Physical Demand

Note:  The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.


The associate is primarily seated while performing the duties of the position.  Occasional walking or standing is required.  The hands are regularly used to write, type, key and handle or feel small controls and objects.  The associate must frequently talk and hear.  Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship

Learn more about Information Technology