Business Analyst - Health Plan (Clinical Space)

About the role

Pinnacle Method Consulting is dedicated to helping job seekers achieve their career goals by connecting them with top-tier opportunities. We do not act as a staffing firm or agency; instead, we source and verify positions directly from premier employers.

Responsibilities

• Work with stakeholders to gather and document business, functional, and non-functional requirements.
• Support Care Management processes such as Assessments, Stratification, and Letters.
• Affiliate with Utilization Management, including Prior Authorization, Turnaround Times, and Policies.
• Collaborate with HealthEdge's Guiding Care system and Electronic Health Records (EHRs).
• Create process flows, diagrams, and traceability matrices.
• Manage requirements using Azure DevOps (ADO).
• Collaborate with teams to build UAT scenarios and support Agile delivery.
• Affiliate with project planning, status reporting, and change management.
• Escalate risks and issues to the Project Manager.

Qualifications

• 10 years of experience as a Business Analyst in Health Plans/Clinical Space.
• Knowledge of Care Management, Utilization Management, and Clinical Policy.
• Experience with Azure DevOps (ADO) and Agile methodologies.
• Strong communication and stakeholder management skills.