Job Functions:

· Lead requirements end-to-end, independently driving discovery, analysis, and solution definition across business and IT stakeholders.

· Serve as a subject-matter expert on 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.

· Prior Experience on HEDIS and Quality process and HEDIS Data is a plus

· 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.

· Mentor and guide junior BAs on best practices in requirements, documentation, analysis, and stakeholder engagement.

· 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.

· Distinguish between routine and sensitive matters and promptly apprise management when needed.

· Ensure requests are addressed promptly, professionally, and with persistence in gathering required information.

· Meet with external vendors to evaluate products and ensure ACFC requirements are met.

· Communicate effectively with senior and mid-level management.

· Understand chain of command, decision-making roles, and communicate accordingly.

· Demonstrate strong analytical and problem-solving skills, including evaluating alternatives, recommending solutions, and articulating impacts.

· Make sound decisions with minimal direction and apply appropriate approaches to each situation.

· Respond promptly to requests related to budgets, operational objectives, reporting, process re-engineering, and business flows.

· Produce clear, well-structured written and verbal communications.

· Brief management appropriately when issues require senior-level attention.

· Maintain regular communication with management and keep staff informed of progress, risks, and priorities.

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.

· Ability to communicate effectively at all organizational levels.

· Advanced proficiency with Microsoft Office Suite.

· Proficiency in SQL, Databricks, and data validation techniques.

· Experience in Agile Delivery with usage of tools like Azure DevOps or JIRA

· General knowledge of healthcare operations (HEDIS, Prior Authorizations, etc.) in a managed-care environment.

· Demonstrated ability to work independently and collaboratively.

· Strong documentation, communication, and problem-solving skills.

· Bachelor’s degree or equivalent experience