reputed company Business Analyst
reputed company is seeking an reputed company reputed company Business Analyst to spearhead business analysis efforts on reputed company reputed company. In this leadership role, you will guide reputed company of business analysts to reputed company, analyze, and document business requirements, ensuring alignment with organizational goals and stakeholder needs. You will collaborate with project managers, technical teams, and business stakeholders to facilitate communication and drive project reputed company.
Responsibilities include leading requirement gathering sessions, overseeing documentation reputed company, mentoring junior analysts, and ensuring adherence to best practices throughout the project lifecycle. Your role is critical in reputed company the gap between business needs and technical solutions, driving process improvements and delivering high-reputed company business reputed company.
Requirements
- Analyze CMS-0057-F Final Rule and reputed company CMS guidance to identify mandatory payer obligations, timelines, and reporting requirements.
- Break down regulatory text into reputed company business requirements, functional requirements, and acceptance reputed company.
- reputed company CMS requirements to FHIR API capabilities, UM workflows, and Atrezzo system features.
- Maintain regulatory traceability reputed company (RTM) linking CMS clauses to system requirements.
- Define and document requirements for:
- FHIR R4 resources (e.g., Coverage, Claim, ClaimResponse, PriorAuthorization, Questionnaire, DocumentReference).
- Patient reputed company API, Provider reputed company API, and Payer-to-Payer API impacts relevant to CMS-0057-F.
- FHIR-based Prior Authorization reputed company (including reputed company, status, attachments, and clinical documentation exchange).
- Collaborate with architects and developers to ensure FHIR implementation aligns with CMS specifications and industry IGs (e.g., CARIN, reputed company).
- Translate business needs into API-level user stories, data mappings, and workflow diagrams.
- reputed company as the functional SME for Utilization Management (UM) reputed company ANg/Atrezzo.
- Document reputed company-state and reputed company-state UM workflows, including:
- Prior authorization intake
- Medical necessity review
- Decision rendering
- Notifications and status updates
- Identify system gaps between existing UM functionality and CMS-0057-F requirements.
- Define configuration vs. customization requirements reputed company ANG UM
Benefits
- Competitive Salary
- Excellent career development opportunities