Business Analyst with Domain FDE

About the Role

We are seeking a seasoned professional with deep healthcare payer expertise to drive solution development, stakeholder alignment, and innovation within our organization. The ideal candidate will bridge business needs and technical execution, ensuring solutions are both visionary and actionable.

Responsibilities

• Articulate point of view (POV) on topics relevant to client business, regulatory changes, and industry drivers to develop contextual POVs, articles, and blogs.
• Collaborate with data scientists, AI architects, and technical teams to ensure rapid solution/POC development.
• Write detailed use cases on requirements with minimal inputs or dependency.
• Support account teams in driving innovation by providing relevant examples of technology applications based on customer needs, AI maturity, current asks, and audience roles.
• Stay abreast of industry-specific trends (e.g., interoperability via FHIR, HL7, EDI), cost-of-care imperatives, and value-based care; continually learn about business model changes and industry factors.
• Apply new technologies (e.g., AI, Generative AI) to real business problems.
• Demonstrate deep understanding of the healthcare ecosystem, value chains, and value exchange between entities.
• Quickly grasp domain adjacencies (e.g., pharmacy dispensing business, PBM business).
• Identify inventive aspects of solutions and file patents, copyrights, and trademarks.
• Steer requirements, seek buy-in, and drive consensus among multiple stakeholders.
• Visualize and create solutions that meet business needs, including initial prototypes or proof of concepts.
• Work with high-level requirements to drive detailed solutioning for various engagements (e.g., proactive pitches to payer business teams, aligning business goals with IT, leading internal IT teams, tracking requirements in product backlogs, specifying user stories, and conducting acceptance/functional testing).
• Evangelize solutions and seek stakeholder buy-in.
• Manage product backlogs, write user stories/use cases, and plan program increments/sprints as a Product Owner.
• Drive teams toward showcasing solutions.
• Write SMART requirements (Specific, Measurable, Accurate, Realistic, Time-bound) using strong analytical skills.

Requirements

• 10+ years of hands-on healthcare payer experience.
• Healthcare claims knowledge, including hands-on experience with claims engines, product & benefits, and claim processing.
• Broad-based understanding of payer functions such as sales and marketing, healthcare product management, membership, providers, prior authorizations, utilization management, claims, and program integrity.
• Awareness of lines of business (e.g., Medicare, Medicaid) and CMS guidelines, along with overall healthcare industry trends.
• Past Product Owner experience managing product backlogs, writing user stories/use cases, and planning program increments/sprints.
• Strong communication and influencing skills.
• Strong analytical skills to write SMART requirements.

Qualifications

Bachelor of Computer Science or equivalent.

Pay

Salary range: $140,000–$160,000 per year.

Benefits

• Discretionary Annual Incentive.
• Comprehensive Medical Coverage: Medical & Health, Dental & Vision, Disability Planning & Insurance, Pet Insurance Plans.
• Family Support: Maternal & Parental Leaves.
• Insurance Options: Auto & Home Insurance, Identity Theft Protection.
• Convenience & Professional Growth: Commuter Benefits, Certification & Training Reimbursement.
• Time Off: Vacation, Time Off, Sick Leave & Holidays.
• Legal & Financial Assistance: Legal Assistance, 401K Plan, Performance Bonus, College Fund, Student Loan Refinancing.