Business Systems Manager (Medicare Advantage)

Job Number:




Onsite Flexibility:


Job Description

Remote Opportunity! But must be located in Eastern or Central time zone

  • Deep understanding of Medicare Advantage operations, requirements, and products
  • Medicare Advantage experience in one or more of the following areas: claims benefits, payment integrity, pricing, enrollment, billing, provider, grievances, and appeals
  • Experience with claims processing; pricing and benefits is an advantage
  • Must be a driver to obtain and document business requirements
  • Strong desire to get to a level of detail in order to build a solution and actually implement
  • Can work with multiple areas regardless of prior knowledge by being highly adaptable
  • Highly collaborative and strong relationship building skills
  • High degree of professionalism with customers and other vendors
  • Must be self-directed
  • Must be analytical and strategic
  • Strong communication skills


  • Independently takes on the business analysis for projects from end to end using a wide variety of BA techniques
  • Plans the business analysis approach, activities, estimates, communications, and requirements management
  • Participates in preparing the business case and benefits of the project
  • Assesses proposed solutions and alternative options
  • Prepares, conducts, documents, and confirms elicitation activities using a variety of techniques
  • Defines and manages transition requirements
  • Manages solution scope
  • Manages requirements conflicts and issues
  • Prepares requirements documentation
  • Ensures requirements traceability
  • Presents requirements to stakeholders and confirms they understand requirements
  • Organizes, prioritizes, specifies, and models requirements using appropriate text, visual, and matrix documentation

Location: Remote – but must be located in Eastern or Central time zone
Business Systems Manager (Medicare Advantage)

TM Floyd & Company offers a generous array of benefits, depending on the length of assignment. We also offer a referral bonus of up to $1,000. Ask us for more details!

TM Floyd & Company participates in E-VERIFY

Job Application

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