Healthcare Business Analyst with HL7 & FHIR

Job Functions

• Conduct end-to-end requirements gathering, independently managing discovery, analysis, and solution definition with business and IT stakeholders.
• Serve as a subject-matter expert on CMS Interoperability and HL7 exchange protocols, including FHIR, CCDs, ADTs, etc.
• Perform hands-on data analysis using SQL, Databricks, and related tools to validate data, troubleshoot issues, and support design decisions.
• Document business and technical requirements, source-to-target mappings, data specifications, business rules, and process flows.
• Support validation and QA by reviewing data outputs, test cases, and results to ensure accuracy and compliance.
• Collaborate with internal teams and external partners with minimal supervision to gather requirements, drive key decisions, and support successful implementations.
• Communicate business and process solutions, recommendations, and issues to ACFC management on a regular basis.
• Document all business process flows related to interoperability initiatives.
• Apply working knowledge of ACFC Managed Care functions (HealthCare Services, Claims, Enrollment, Quality/HEDIS, Risk Adjustment, Care Management, Utilization Management) to support problem-solving and solution design.
• Provide strong communication and status updates to business and IT stakeholders and management.
• Build consensus among users, IT, and senior leadership on business problems and solution approaches.
• Address most inquiries independently, escalating only when appropriate.

Qualifications

• 8-10 years of experience in healthcare IT, data integration, or business analysis.
• Experience with FHIR, HL7 clinical data-exchange standards (CCD/ADT/SIU) and healthcare terminology (LOINC, ICD-10, CPT, etc.).
• Ability to interpret large datasets and deliver evidence-based recommendations.
• Strong organizational, analytical, and interpersonal skills.