All fields marked * are required
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
Required
Preferred
All fields marked * are required
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
Required
Preferred