New

Senior Business Process Analyst- REMOTE

TEKsystems
$25.00 - $30.00 / hr
life insurance, sick time, 401(k), retirement plan
United States, Minnesota, Minneapolis
Apr 22, 2026
Description Position Overview The Centers for Medicare & Medicaid Services (CMS), on behalf of the U.S. Department of Health & Human Services (HHS), conducts annual Risk Adjustment Data Validation (RADV) audits to ensure the accuracy and integrity of risk adjustment submissions. This Operational Business Analyst plays a critical role in supporting RADV audit operations, analytics, and data quality initiatives. The position contributes directly to the accuracy, compliance, and successful delivery of RADV audit requirements by reviewing, validating, and resolving demographic, enrollment, and claims-related data issues, including project status reporting. This role is ideal for a detail-oriented, organized, and analytical professional who thrives in a fast-paced, highly regulated healthcare environment and enjoys collaborating across teams to deliver accurate, compliant outcomes. Key Responsibilities * Maintain and update Excel-based tracking tools and audit documentation * Review and validate member demographics, enrollment, and eligibility data to ensure accuracy and audit readiness * Review pharmacy and claims documentation to confirm data completeness and accuracy * Monitor reporting outputs to identify missing or discrepant diagnoses impacting member health status Hierarchical Condition Categories (HCCs) * Research and resolving data discrepancies across source systems; escalating risks, issues, and barriers promptly to leadership * Prepare and deliver weekly project status updates * Participate in RADV data submission planning and serve as a key point of contact for correcting data issues * Collaborate closely with internal teams and external vendors to ensure audit milestones are met * Monitor and apply CMS guidelines, manuals, and regulatory updates * Uphold HIPAA and data privacy standards when handling protected health information * Attend and actively participate in cross-functional and project meetings * Adapt to changing priorities and support additional cross-functional initiatives as assigned What You'll Bring * Strong analytical and problem-solving skills with exceptional attention to detail * Ability to manage multiple priorities and deadlines in a remote, fast-paced environment * Clear, professional written and verbal communication skills, including virtual collaboration across time zones * Proven ability to work independently while collaborating effectively with diverse stakeholders * Judgment to recognize when issues should be escalated to leadership Skills Business analysis, claims management Top Skills Details Business analysis Additional Skills & Qualifications Required Qualifications * 5+ years of healthcare industry experience, including claims, membership, provider, or eligibility data * 5+ years of experience in business analysis, operations or analytical role * Intermediate proficiency in Microsoft Excel (e.g., filters, formulas, data reconciliation) * Demonstrated ability to work independently with minimal supervision * Strong organizational, time management, and prioritization skills * Results-driven mindset with a continuous improvement approach Preferred Qualifications * Intermediate to advanced Microsoft Excel proficiency (e.g., pivot tables, VLOOKUP/XLOOKUP) * Experience in operational or process management within healthcare * 3+ years of HHS-RADV experience, including working knowledge of HHS risk adjustment models, audit protocols, and CMS guidance * Familiarity with risk adjustment, HCC models, or regulatory audit environments Why This Role? * Meaningful impact supporting federal healthcare programs and data integrity * Opportunity to work with cross-functional experts and high-visibility audit initiatives * Remote flexibility with structured support and clear deliverables * Ideal for experienced analysts seeking a challenging, compliance-focused engagement Enable Skills-Based HiringNo Onshore/Offshore Onshore Resource Type Non IT Contractor What Segment will this Contractor(s) Support? UnitedHealthcare Finance Is this position for TriCare related work, and if yes, what pay grade equivalency? No - This position is not TriCare related This position requires professional certification? No Minimum Education Requirement Highschool/GED or equivalent Experience Level Expert Level Job Type & LocationThis is a Contract position based out of Minneapolis, MN. Pay and BenefitsThe pay range for this position is $25.00 - $30.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: * Medical, dental & vision * Critical Illness, Accident, and Hospital * 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available * Life Insurance (Voluntary Life & AD&D for the employee and dependents) * Short and long-term disability * Health Spending Account (HSA) * Transportation benefits * Employee Assistance Program * Time Off/Leave (PTO, Vacation or Sick Leave) Workplace TypeThis is a fully remote position. Application DeadlineThis position is anticipated to close on May 1, 2026. h4>About TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. About TEKsystems and TEKsystems Global Services We're a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We're a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We're strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We're building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.