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Technical Business Analyst, Health Data Interoperability

Industry Other
Category Information Technology
Location Lalitpur, Nepal
Expiry date Jul 30, 2025 (7 days left)

Job Description

We are seeking an experienced Technical Business Analyst with Health Data Interoperability and/or CMS Interoperability subject matter expertise to join our growing team. You will act as a liaison between business stakeholders, data modeling, and technical teams, ensuring compliance with healthcare regulations, seamless data exchange, and efficient data integration between formats and systems. You will contribute expertise and experience in health data interoperability, data mapping and transformation, and technical requirements gathering and analysis to help optimize internal work process coordination and efficiency and help build client-facing platform solutions that drive business value for payers in critical program areas like CMS Interoperability and related programs. This role will help translate business requirements into actionable, documented technical requirements for hand-off to Implementation and Engineering teams for client onboarding and product development.

You Will Be Responsible for:

Requirements Gathering and Analysis. Define, analyze, and document detailed functional and technical requirements for specific data solutions. Tasks may include collecting requirements from internal SMEs, partnering closely with Client Delivery and/or Customers to gather and refine technical and business requirements, developing and reviewing QA/user acceptance testing criteria, and business systems analysis, including data and gap analyses.
Stakeholder coordination/collaboration: Be a knowledgeable bridge between clients, product management, data modeling, SMEs, and other team members to define, document and share detailed functional and technical requirements and expected impact using all of the tool in your technical BA toolkit.
Mock-ups/Prototyping: Create mocks-ups, sample reports, and/or output tables to help visualize and communicate requirements, workflows, and expected results, based on client problems to be solved, business rules, and technical requirements.
User Acceptance Testing/QA Process. Collaborate with key stakeholders to define user stories, test cases, QA/User acceptance testing criteria for data solutions.
Partnering with Agile Scrum Teams: Participate in relevant agile ceremonies, build user stories according to requirements, and help define test cases and acceptance criteria.
Solution Maintenance. Co-own maintenance and create of artifacts that includes but is not limited to document portal/repository, workflows/diagrams, data mapping and technical requirements documents, analytics/business logic, user stories, and UAT scenarios and test cases.

Must-Have Qualifications:

Deep understanding of Health Data Interoperability frameworks and/or CMS Interoperability Rules (e.g., CMS-9115-5, CMS-0057-F, FHIR standards)

5+ years of experience working with US healthcare data (claims, clinical, member, provider, CMS files, etc.), standards (e.g., HL7, FHIR, EDI, CDA) and integration (i.e. ePA / Prior Authorization, UM / Utilization Management, CM / Care Management)

5+ years of progressive experience in business requirements management (definition, documentation, mock-ups, data analysis

3+ years experience participating in UAT process management – test case planning and scenarios, writing UAT acceptance criteria, UAT test case execution, tracking and resolving defects, and UAT closure

Proficiency in data mapping and data exchange protocols (e.g., API, JSON, XML) related to health information systems.

Proficiency in SQL, Python, and/or other programming languages for data extraction and transformation.

Experience with Agile methodologies in healthcare technology projects.

Experience with EHRs and/or HIEs and healthcare data workflows.

Strong communicator who can share domain expertise effectively across multiple departments from Sales, Client Delivery, Product, Engineering, and Information Security

"Roll up your sleeves mentality" working side-by-side with your team.

Self-starter with demonstrated ability to drive workstreams independently and manage risks with strong compass on when to escalate issues.

Demonstrated ability to thrive in a fast-paced, dynamic startup environment.

Nice-to-Have Qualifications:

Working knowledge of US healthcare (one or more) - health insurance markets, government sponsored health plans (Medicare/Medicaid), and/or care delivery and reimbursement models (e.g. VBC, population health, risk adjustment)