CareFirst Careers

Lead Business Analyst

Resp & Qualifications

Under the general supervision, the incumbent’s accountabilities may include, but are not limited to, the following:

Lead and participate at an expert-level with the feasibility of the most complex enhancements, automations and implementations review, analysis, and evaluation of current and future business processes. Explore alternative business solutions - is liaison to business/IT/Shared Services to explain choices and implications - works closely with system analyst to help create POCs and alternative solutions to create, maintain and enhance business value. Develop solutions that solve the most complex technical and/or business issues.  Proactively identifies opportunities and enhancements. Independently lead or participate in all phases of the software development life cycle, with focus on defining the underlying business needs, documenting those needs, validating conceptual systems designs, and assuring delivery quality through comprehensive testing and training.

Analyze define and interpret business needs and issues by gathering, analyzing, documenting and validating the Business area(s) and user(s) technical (functional/non-functional) requirements. Create PRD (Project Requirements Document) for most complex enhancements, automations and implementations including defining Business, User and functional and non-functional requirements needed for approval by Business and for use by Design, Development and Testing teams. Create Requirements Management Plan to define, organize and schedule requirements management and development activities. Lead requirements analysis and verification sessions. Produces Requirements Tracebility Matrix (RTM) and RTM gap analysis reports. Track and manage open issues and plan for resolution. Troubleshoot systems problems, identify cause of problems, work with appropriate group to correct problem. Maintain communications with technical counterparts to guide the issues to cross-functional resolution and adopt best practices and ensure integration of specific application architecture into overall enterprise technology strategy.

Lead testing efforts by defining, developing and implementing practices and procedures for complete end user test plans. Ensures all tests are conducted and documented according to standards. Identifies and documents system deficiencies and recommends solutions. Responsible for overall success of testing, including results verification and release. Coordinates groups of end users who test, evaluate and validate new functions and applications and identify issues in software or services. Ensures continuing operational quality by documenting fixes and enhancements. Providing guidance and training to application end users. Provides ongoing assistance to software developers and testers to resolve defects during the testing process. Leads development sessions and design reviews in order to ensure design meets user requirements.

Reviews, edits, analyze and create detailed documentation of business systems and user needs. Responsible for writing all documentation in clear and well organized manner including SOPs and training manuals.

Use project management techniques to establish roles and responsibilities, monitor project and request status and workload, and ensure deliverables of high quality, effectiveness and timeliness. Manages assigned enhancements, automations and implementations from concept through implementation. Creates, develops and maintains project schedules for key deliverables by developing project plan, monitoring milestone completion and coordinating project progress. Develops key project deliverables including requirements specifications, use cases, system test cases, training and documentation and user manuals for the most complex enhancements, automations and implementations.  Manages the sequencing of releases to meet business needs.

The incumbent has no direct reports however this position will provide guidance, expertise, coaching and mentoring to less experienced analysts or other project team members.

Required: This position requires a bachelor’s degree in Information Technology, Computer Science or Business or relevant work experience in business analysis, systems analysis and/or testing background and 6+ years of direct Business Analyst experience.

• Experience in business process analysis, Work flow, task analysis, user acceptance testing and requirements analysis.
• Proven ability to elicit, document, analyze and verify requirements.
• Strong experience with user acceptance testing concepts.
• Proven ability to work well as a team.
• Demonstrated ability to lead problem solving business/technology teams and projects.
• Technical writing experience and training experience.
• Minimum of 4 years of demonstrated successful use of SDLC methodology or demonstrated knowledge of business processes related to the business area supporting.
• Must demonstrate understanding of industry standard Business Analysis Best Practices.

EDI Skills

  • X12 transactions ( 837I, 837P,837D,27X)
  • Compliance
  • WPC Code Sets

HealthCare Industry Knowledge

  • BCBS
  • Medicare
  • Medicaid
  • Role of the Trading Partner
  • WEDI
  • CAQH
  • NUBC
  • NUCC


  • Ability to Gather and Document technical and user Requirements
  • Test

Other Technical

  • AS2
  • SFTP
  • SQL
  • Microsoft Office including TEAMS


  • Manage small projects
  • Track and Manage Issues
  • Oral and Written Communication skills
  • Analytical Skills
  • User documentation and training



Department:EDI Business Operations

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: 4/14/21

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 Business Operations