We are looking for a highly experienced and motivated Lead Business Analyst with deep expertise in the Healthcare Payer domain and proficiency in data analytics to guide transformative initiatives.
As a Subject Matter Expert (SME), you will play a pivotal role in bridging business objectives and technical solutions, working at the intersection of healthcare insights and innovative data strategies.
Responsibilities
- Work with stakeholders to gather, analyze, and document business needs within the Healthcare Payer domain
- Define and maintain prioritized product backlogs, aligned with business objectives and compliance standards
- Act as a key liaison, translating business needs into detailed user stories and technical specifications
- Analyze payer data, including healthcare claims, to uncover insights and assess operational opportunities
- Create actionable dashboards, data visualizations, and reports to support strategic decisions
- Partner with cross-functional teams, ensuring data accuracy, integrity, and adherence to security policies
- Monitor and adapt to changes in healthcare regulations, payer guidelines, and emerging industry trends
- Act as a communication bridge between technical teams, business stakeholders, and external partners
- Lead the validation, testing, and go-live phases for new data-driven solutions or system enhancements
Requirements
- Bachelor's degree in Computer Science, Healthcare IT, or a related field; Master's preferred
- 9-12 years of experience as a Business Analyst, Product Owner, or similar role in the Healthcare Payer domain
- Strong expertise in claims processing, provider network management, and payer business policies
- Extensive experience with data tools, including Tableau, Power BI, and SQL, for analytics and reporting
- Understanding of healthcare standards, such as HIPAA regulations, ICD, CPT, and HCPCS
- Competency in Agile/Scrum methodologies for product development
- Ability to synthesize complex data into actionable business insights
- Exceptional skills in stakeholder management and problem resolution
Nice to have
- Background in healthcare platforms and ETL processes
- Knowledge of machine learning and predictive modeling specific to healthcare analytics
- Certification such as CBAP, CSPO, or similar qualifications
