
Healthcare Transformation Specialist
2 days ago
This Business Analyst role is an excellent opportunity to leverage your analytical skills and business acumen in a dynamic healthcare setting. As a key member of the team, you will be responsible for analyzing current workflows, identifying gaps, and implementing process improvements.
The ideal candidate will have strong experience in Utilization Management and Case Management, with a proven track record of success in similar roles. They will also possess excellent communication and stakeholder engagement skills, as well as proficiency in business analysis tools such as JIRA, Confluence, and Visio.
- Responsibilities:
- Analyze and document current workflows, identifying areas for improvement and opportunities for growth.
- 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).
To be successful in this role, the ideal candidate will possess the following qualifications and skills:
- Experience: 5-7 years as a Business Analyst in healthcare, insurance, or managed care settings.
- Skills: 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.
- Certifications: Certification in Business Analysis (CBAP, PMI-PBA) or Healthcare IT (e.g., CPHIMS).
As a valued member of our team, you can expect a range of benefits including:
- Hybrid Work Model: Balance your work and personal life with our flexible hybrid work model.
- Professional Growth Opportunities: Develop your skills and career with our comprehensive training programs and mentorship opportunities.
- Recognition and Rewards: Celebrate your achievements and contributions with regular recognition and rewards.
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