Senior Business Analyst
Temporary
USM
Role Description
Seeking a Senior Business Analyst with strong experience in US Healthcare Payer, CMS Interoperability, and ONC Mandates, specifically focused on Patient Access API implementations. The role involves:
- Gathering requirements
- Managing healthcare data integration
- Ensuring regulatory compliance
- Supporting interoperability initiatives
Location: Remote
Duties
- Gather and document business and functional requirements for CMS Interoperability initiatives.
- Lead requirement analysis for Patient Access API projects.
- Work with business and technical teams to define member, claims, provider, and clinical data requirements.
- Analyze historical healthcare data and support data mapping activities.
- Create business process flows, user stories, BRDs, FRDs, and acceptance criteria.
- Facilitate stakeholder meetings and requirement workshops.
- Support UAT planning, testing, and defect resolution.
- Ensure compliance with CMS, ONC, FHIR, and interoperability standards.
- Collaborate with architects and developers on API integrations and data transformation requirements.
Qualifications
- 8+ years of Business Analyst experience in the US Healthcare Payer domain.
- Hands-on experience with CMS Interoperability and ONC Mandates.
- Experience implementing or supporting Patient Access APIs.
- Strong knowledge of healthcare data, including:
- Claims
- Clinical
- Eligibility
- Member data
- Knowledge of FHIR, HL7, and REST APIs.
- Strong requirements gathering, documentation, and stakeholder management skills.
- Experience in creating User Stories, BRDs, FRDs, and Acceptance Criteria.
- Understanding of healthcare regulatory compliance requirements.
Desired
- Experience with:
- Provider Access API
- Payer-to-Payer Data Exchange
- Prior Authorization initiatives
- Experience working in Agile/Scrum environments.
- Exposure to healthcare data platforms and cloud technologies.
- Strong communication and client-facing skills.
Vacancy posted 5 hours ago
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