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Cosette Network

Sr Business Analyst

remote8.0 - 10.0 years

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Job Description

Job Role: Sr Business Analyst

Total experience: 8+yrs

Job Location: Remote

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

 


Skills

Required

sqldatabricksazure devopsjira

Preferred

hl7fhirloincicd-10cptmicrosoft office
Sr Business Analyst at Cosette Network | Talynce Jobs