Lead Business Analyst

Lead Business Analyst

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