About the Company
ThreatXIntel is a fast-growing Cybersecurity, IT Staffing, and Consulting company delivering end-to-end technology and security solutions. Our expertise spans cloud security, web & mobile application security testing, DevSecOps, vulnerability assessments, IT consulting, and professional staffing services.
We support global corporate clients by deploying skilled professionals across IT and finance domains, helping organizations strengthen compliance, optimize operations, and scale efficiently.
Role Overview
We are looking for a Lead Technical Business Analyst with strong expertise in Healthcare Interoperability, CMS regulations, and FHIR-based APIs.
This role requires a professional who can effectively bridge regulatory requirements and technical implementation, ensuring compliance while driving scalable solutions.
Key Responsibilities
- Analyze CMS-0057-F regulations and related CMS guidance
- Identify payer obligations, compliance requirements, and timelines
- Translate regulatory requirements into:
- Business requirements
- Functional specifications
- Acceptance criteria
- Map CMS requirements to:
- FHIR API capabilities
- Utilization Management (UM) workflows
- Atrezzo system functionalities
- Maintain Regulatory Traceability Matrix (RTM)
- Define and document requirements for:
- FHIR R4 resources (Coverage, Claim, Claim Response, Prior Authorization, Questionnaire, Document Reference)
- Patient, Provider & Payer-to-Payer APIs
- FHIR-based Prior Authorization workflows
- Collaborate with architects and developers on industry standards (CARIN, Da Vinci implementation guides)
- Convert business needs into:
- API-level user stories
- Data mappings
- Workflow diagrams
- Act as SME for Utilization Management (UM)
- Document current and future state workflows
- Identify system gaps vs CMS requirements
- Define configuration vs customization in ANG/Atrezzo systems
Mandatory Skills
- Lead-level Business Analysis experience
- Strong knowledge of CMS Regulations
- Experience in EDI Transactions & Healthcare Interoperability
- Expertise in HL7 & FHIR (R4)
Good to Have
- Strong stakeholder management skills
- Excellent requirements documentation & communication
Ideal Candidate
- Experience working with US Healthcare systems
- Hands-on exposure to FHIR APIs and Prior Authorization workflows
- Ability to work in a cross-functional, fast-paced environment
