Business Analyst

Independence Blue Cross -
Philadelphia, PA

Apply Now

Job Details

1 day ago

Qualifications

Defect resolution root cause analysis
Metrics Reporting
Bachelor's degree
Quality control problem-solving
Root cause analysis
Excel data analysis

Full Job Description

The Business Analyst supports vendor performance management for Appeals operations by analyzing performance data, identifying root causes of quality and compliance gaps, and supporting governance routines. This role partners with internal teams and vendor partners to improve appeals accuracy, turnaround time, and overall service performance while ensuring adherence to regulatory and contractual requirements.

Primary Responsibilities

Assist Vendor Onboarding and Offboarding activities through the contract lifecycle
Analyze Appeals performance (TAT, quality, overturn rate, inventory, productivity) to identify trends and risks
Monitor appeals inventory and case aging to support timely and compliant processing
Conduct root cause analysis on quality defects, overturns, and documentation gaps
Support vendor oversight, including SLA monitoring and issue resolution tracking
Develop reporting and executive-ready summaries for leadership and business reviews
Support Monthly Business Reviews and vendor governance routines
Identify and support process improvements to enhance accuracy, efficiency, and compliance
Partner with Operations, QA, Compliance, and vendor teams to drive performance outcomes

Minimum Qualifications

Bachelor’s degree in Business, Healthcare Administration, or related field
2–5 years of experience in business analysis, operations, or healthcare environment
Strong analytical skills and experience working with performance metrics
Advanced Excel skills and experience developing reports
Strong written and verbal communication skills
Proven problem-solving and root cause analysis experience

Preferred Qualifications

Experience in healthcare appeals or grievance operations
Familiarity with compliance/regulatory requirements (e.g., CMS, NCQA)
Experience supporting vendor/offshore operations or BPO environments
Knowledge of performance metrics (TAT, overturn rate, quality, inventory)
Experience with reporting tools (Power BI, Tableau, SQL)
Knowledge of process improvement methodologies (Lean, Six Sigma)

Independence has implemented a “Hybrid” model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the “Hybrid” model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania.

IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.

Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.

Apply Now

Primary Responsibilities

Minimum Qualifications

Preferred Qualifications

Job Seeker Tools

Employer Tools

Browse

Stay Connected