Posted:2 days ago|
Platform:
On-site
Contractual
Our Client is a global IT services company headquartered in Southborough, Massachusetts, USA. Founded in 1996, with a revenue of $1.8B, with 35,000+ associates worldwide, specializes in digital engineering, and IT services company helping clients modernize their technology infrastructure, adopt cloud and AI solutions, and accelerate innovation. It partners with major firms in banking, healthcare, telecom, and media.
Our Client is known for combining deep industry expertise with agile development practices, enabling scalable and cost-effective digital transformation. The company operates in over 50 locations across more than 25 countries, has delivery centers in Asia, Europe, and North America and is backed by Baring Private Equity Asia.
Collaborate with clinical, operational, and IT teams to gather and validate business requirements.
Translate business needs into functional specifications for system enhancements or new implementations.
Support the design and deployment of digital solutions that streamline prior authorization, care planning, and member engagement.
Conduct impact analysis and support change management initiatives across UM and Case Management functions.
Develop and maintain process maps, user stories, and test cases.
Monitor KPIs and performance metrics to assess workflow efficiency and compliance.
Ensure alignment with regulatory requirements (e.g., NCQA, CMS, HIPAA).
5-7 years of experience as a Business Analyst in healthcare, insurance, or managed care settings.
Strong understanding of Utilization Management and Case Management processes and systems.
Experience with workflow tools, EHR/EMR platforms, or care management systems.
Proficiency in business analysis tools (e.g., JIRA, Confluence, Visio).
Excellent communication, documentation, and stakeholder engagement skills.
Experience with platforms like InterQual, MCG, or Care Advance.
Familiarity with value-based care models and population health strategies.
Certification in Business Analysis (CBAP, PMI-PBA) or Healthcare IT (e.g., CPHIMS).
Experience working in Agile or hybrid project environments.
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