Position: Lead Business Analyst
Location: Philadelphia, PA
Duration: 6+ Months
Remote position but candidate needs to be local and willing to be onsite if needed.
Primary Focus
New product operational readiness and post-launch oversight
Scope
Customer service, claims, enrollment, and supporting teams
Position Summary
Seeking an experienced operations professional to provide hands-on oversight during the implementation and early stabilization of a new, highly visible product. This individual will serve as the day-to-day operational point person, proactively identifying issues, coordinating timely resolution, supporting team readiness, and maintaining clear controls and escalation pathways.
Key Responsibilities
Operational oversight: Monitor customer service, claims, enrollment, and supporting functions to identify gaps, inconsistencies, emerging trends, and areas requiring adjustment.
Call, transcript, and work review: Conduct frequent call listening and targeted transcript, claims, and enrollment reviews to identify misinformation, process breakdowns, training needs, and service risks.
Issue resolution and escalation: Establish practical intake, triage, ownership, escalation, and closure processes. Resolve routine questions directly and elevate issues requiring leadership attention.
Real-time operational support: Serve as an accessible point of contact through a chat-based or similar channel, clarify questions, and coordinate accurate, timely responses.
Training and readiness: Support initial training and role-based readiness activities so impacted teams understand the product, how it affects their work, and how to explain it accurately.
Controls and quality assurance: Implement monitoring and quality controls, verify corrective actions, and confirm changes are working as intended.
Tracking and reporting: Partner with the Project Manager to maintain an integrated issue and action tracker and provide concise updates on risks, trends, decisions, progress, and items requiring intervention.
Continuous improvement: Connect issues across functions, reinforce effective practices, and recommend sustainable process, training, communication, or control improvements.
Expected Deliverables
Operational readiness and oversight plan for the engagement period.
Documented question intake, triage, escalation, and resolution process.
Integrated issue and action tracker with owners, priorities, status, and due dates.
Regular findings from operational reviews and concise executive-level status updates.
Role-based training support, job aids, and talking points as needed.
Transition plan with sustainable controls and ownership for ongoing operations.
Qualifications
7+ years of experience in self-funded medical insurance operations, implementation readiness, quality assurance, issue management, or a related role in a complex service environment.
Strong knowledge of customer service operations and the interdependencies among service, claims, enrollment, training, and implementation teams.
Experience identifying operational risk through call monitoring, transcript analysis, data review, claims review, or similar quality activities.
Demonstrated ability to build practical processes, controls, escalation pathways, and reporting routines in a fast-moving environment.
Strong judgment, organization, follow-through, and ability to translate complex issues into clear guidance and executive-level reporting.
Health plan administration, benefits administration, claims operations, or similarly regulated experience strongly preferred.
Benefits:
We offer a competitive compensation package that includes:
· [Pay Rate]: $45 per hour W2
o Note: Pay rate will be commensurate with experience.
· Medical for full time employees
· Dental, and Vision Insurance
· Life Insurance, Short-Term Disability, Long-Term Disability, etc.