Clinical Business Systems Analyst- Vendor Integration

Candidate must be a US Citizen (due to contractual/access requirements).

About the role

The Clinical Business Systems Analyst leads the requirements, development, and delivery of clinical data products that support critical business and healthcare outcomes. This role serves as the primary liaison between business stakeholders, clinical subject matter experts, vendor partners, and technology teams to translate complex clinical and operational needs into scalable data and analytics solutions.

The position oversees the full development lifecycle, including requirements gathering, testing, quality assurance, issue resolution, and capability enablement across multiple teams and systems. A key responsibility is managing and overseeing complex vendor clinical data integrations, including defining and validating file specifications, data mapping, data transformation requirements, and data exchange processes between the organization and external partners. The role ensures data quality, interoperability, regulatory compliance, and alignment with enterprise data strategies while coordinating dependencies, mitigating risks, removing delivery blockers, and driving successful implementation of clinical data solutions.

The successful candidate will possess strong knowledge of clinical data sources, clinical coding methodologies, healthcare data exchange standards, and disease processes, enabling effective evaluation of business needs and development of data products that support clinical outreach, care coordination, and member engagement. This individual will work closely with vendors and internal technical teams to facilitate secure and reliable exchange of clinical data, validate file layouts and business rules, troubleshoot integration issues, and ensure accurate delivery of data across interconnected systems. Acting as a trusted advisor to stakeholders, the Business Systems Analyst leads complex initiatives with significant operational, financial, and regulatory impact, and serves as a subject matter expert for clinical data product development, external data integrations, and digital vendor partnerships.

Responsibilities

• Take a lead role with customers, Software Engineers, Architects, Capability Managers, and other team members to capture capability needs and drive quality business solutions on complex issues.
• Create and maintain deliverables such as business vision, requirements, testing plan, testing schedule, testing scenarios, testing outcomes, user task analysis, wire framing, usability testing, personalization to different clients, and user interface design.
• Participate in the full software development life cycle by actively taking a lead role on agile scrum teams in various roles, including, but not limited to, Scrum Master, Business Technical Analyst, User Interface designer, Capability Manager, or Tester, based upon experience and need.
• Provide required business and/or subject matter expertise for both project and production related activities on complex issues, including new strategic programs or initiatives impacting current and existing systems.
• Ensure compliance for required standards and all necessary approvals have been obtained throughout the project lifecycle.
• Interface with the business areas, customers, partners, vendors, technical staff and project teams to drive value, return on investments and innovative solutions. This includes providing alternative solutions, including vendor solution acquisitions, with maximum benefits while reducing cost (e.g., cost benefit analysis, pros/cons of solutions).
• Take lead role in supporting various aspects of requirements testing (e.g., testing plan, scenarios, documentation, defect management) to ensure minimal production defects are realized and completing analysis of the results tying back to customer impacts.
• Communicate in an exemplary manner with team members, customers, partners and management, including assisting with or conducting requirement walkthroughs and sprint reviews, reporting project status, enabling vendor solutions and providing accurate and concise documentation.
• Provide thought leadership and strategic direction in Product and Technology Solutions.
• Other duties as assigned.

Requirements

• Bachelor's Degree in Business Management, Information Technology, Information Systems, or related field (Required).
• Bachelor's Degree in Nursing or related field (Preferred).
• Associates degree with 5+ years of experience (as a substitute for Bachelor's degree).
• 5 - 7 years in IS/IT (Required).
• 3 - 5 years in Lean/Six Sigma (Preferred).
• 3 - 5 years in the Health Insurance Industry (Preferred).
• 3 - 5 years in the Healthcare Industry (Preferred).
• Clinical License (Preferred).

Skills

• Analytical Skills
• Problem-Solving
• Communication Skills
• Report Writing
• SQL
• Project Management
• Customer Service
• Leadership
• Agile Methodology
• Agile Project Management

Working Conditions

• Position Type: Office-Based
• Travel required: 0% - 25%
• Teaches / trains others regularly: Rarely
• Travel regularly from the office to various work sites or from site-to-site: Occasionally
• Works primarily out-of-the office selling products/services (sales employees): Never
• Physical work site required: Yes
• Lifting up to 10 pounds: Rarely
• Lifting 10 to 25 pounds: Rarely
• Lifting 25 to 50 pounds: Rarely

Pay

Pay Range Minimum: $79,300.00

Pay Range Maximum: $127,100.00

Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.