Position Summary

Key Responsibilities

• Partner with business stakeholders, product owners, solution architects, developers, QA teams, and project managers to define business objectives and solution outcomes.
• Plan and facilitate workshops, interviews, discovery sessions, and process walkthroughs to understand current-state workflows, pain points, and improvement opportunities.
• Elicit, analyze, and document business requirements, functional requirements, user stories, use cases, process flows, business rules, and acceptance criteria.
• Create and maintain high-quality BRDs, FRDs, workflow diagrams, decision logs, requirement traceability matrices, and supporting project documentation.
• Analyze current business processes and recommend improvements that optimize operational efficiency, reduce manual effort, and improve stakeholder experience.
• Support Agile ceremonies, including backlog refinement, sprint planning, story elaboration, estimation support, and sprint reviews.
• Collaborate throughout the software development lifecycle to ensure requirements are understood, solution design is aligned, and delivery outcomes meet business intent.
• Facilitate User Acceptance Testing (UAT), define test scenarios, validate results against requirements, triage defects, and support business sign-off.
• Manage requirement traceability from business objectives through solution design, development, testing, deployment, and adoption.
• Support change management, training material development, release readiness, and operational documentation as needed.
• Ensure solutions and documentation align with healthcare regulations, organizational standards, data privacy expectations, and compliance requirements.

Required Qualifications

• Bachelor's degree in Business, Information Systems, Healthcare Administration, Computer Science, or a related field.
• 7+ years of experience as a Business Analyst, including at least 5 years in the healthcare industry.
• Strong experience in requirements elicitation, stakeholder interviews, requirements analysis, process modeling, and functional documentation.
• Hands-on experience working in Agile/Scrum delivery environments.
• Proficiency with tools such as Azure DevOps, Jira, Visio, Microsoft Office, and BPMN/UML modeling tools.
• Strong analytical, problem-solving, written communication, verbal communication, facilitation, and presentation skills.
• Demonstrated experience collaborating with cross-functional teams, product leadership, technology teams, operational users, and executive stakeholders.

Preferred Qualifications

• PBM experience: Knowledge of pharmacy claims, formulary management, prior authorization, rebate management, specialty pharmacy, and eligibility and benefits.
• Healthcare data standards: Familiarity with HL7, FHIR, and healthcare interoperability concepts.
• Data skills: Experience with SQL, data analysis, reporting, metrics interpretation, and operational dashboards is an advantage.
• Certifications: CBAP, PMI-PBA, Agile, Scrum, or related business analysis certifications are preferred.

Desired Skills

• Excellent stakeholder management, executive communication, and facilitation skills.
• Strong documentation, presentation, and storytelling abilities.
• Ability to translate complex business needs into clear, testable, and actionable functional specifications.
• Critical thinking and structured problem-solving capabilities.
• Strong attention to detail with the ability to manage multiple priorities and competing timelines.
• Self-driven, collaborative, adaptable, and comfortable working in a fast-paced environment.

Nice to Have

• PBM implementation, migration, or modernization project experience.
• Experience with Medicare, Medicaid, or Commercial health plans.
• Knowledge of cloud-based healthcare platforms, data platforms, and AI-enabled healthcare solutions.