Business Systems Analyst
Job Description
Code Editor Business Systems Analyst (Optum CES / Facets) – Hybrid
Location: Grand Rapids, MI (Hybrid — onsite Tuesdays)
Schedule: Full-time, 40 hours/week
A high-impact opportunity for a seasoned Business Systems Analyst with deep experience in Optum Claims Editing System (CES) and Facets. In this role, you’ll drive claims edit configuration, requirements, and system alignment work that directly improves claims adjudication workflows. If you’ve worked hands-on with Optum CES configuration/edit implementation, understand payer strategy impacts, and can partner across IT and business teams, this Business Systems Analyst role is built for you.
Responsibilities
- Lead business and systems analysis to define scope, objectives, and functional requirements for claims editing initiatives
- Drive Optum CES configuration support, edit implementation, and workflow alignment with Facets integration
- Partner cross-functionally to analyze issues, troubleshoot defects, and stabilize claims adjudication processes
- Document business requirements, process flows, and system logic; support validation and implementation readiness
- Support systems development lifecycle (SDLC) activities including requirements gathering, analysis, and design support
- Communicate clearly with stakeholders and translate complex technical details into actionable next steps
- Stay current on healthcare payer trends, claims editing best practices, and impacts to existing configurations
- Provide guidance and support to less-experienced analysts as needed
Qualifications
- Must have: Optum Claims Editing System (CES) experience
- Must have: Facets integration/experience
- Nice to have: Epic Tapestry exposure
- Associate’s degree / technical school or equivalent experience (Bachelor’s preferred)
- 2+ years relevant experience in business systems analysis (3+ preferred)
- Strong skills in requirements documentation, workflow analysis, and systems troubleshooting
- Experience participating in multi-phase integrated system implementations preferred
- Healthcare payer / claims adjudication / utilization workflow familiarity strongly preferred
Job Requirements
Qualifications
- Must have: Optum Claims Editing System (CES) experience
- Must have: Facets integration/experience
- Nice to have: Epic Tapestry exposure
- Associate’s degree / technical school or equivalent experience (Bachelor’s preferred)
- 2+ years relevant experience in business systems analysis (3+ preferred)
- Strong skills in requirements documentation, workflow analysis, and systems troubleshooting
- Experience participating in multi-phase integrated system implementations preferred
- Healthcare payer / claims adjudication / utilization workflow familiarity strongly preferred