Job Description

Senior Business Analyst

Need a Business Analyst with experience in Clinical Operations in Pharma / Healthcare

Location : New Jersey (Look for candidates in and around Nj within commutable distance)

It's a Hybrid role and the candidate may have to work from the client location as needed but will be remote for most part.

We are seeking a detail-oriented and analytical Business Analyst with expertise in the Healthcare domain to bridge the gap between business needs and technology solutions. The role involves gathering requirements, analyzing healthcare processes, and working with cross-functional teams to deliver solutions that improve patient care, operational efficiency, and compliance.

Key Responsibilities

1. Requirements Gathering & Analysis
   • Collaborate with stakeholders (clinicians, payers, administrators, IT teams) to elicit and document business requirements.
   • Analyze existing healthcare processes (claims, billing, EHR, patient management, etc.) to identify gaps and opportunities.
   • Translate business requirements into functional and technical specifications.
2. Domain Expertise
   • Apply knowledge of healthcare regulations (HIPAA, ICD-10, CPT, HL7, FHIR, CMS guidelines).
   • Work with teams on healthcare data exchange, compliance, and reporting needs.
   • Understand payer and provider workflows (claims processing, prior authorization, member/patient management).
3. Solution Design & Documentation
   • Develop use cases, workflows, process flows, and system requirement specifications.
   • Support design of healthcare applications (EHR, claims systems, population health management tools).
   • Participate in data mapping and integration efforts across healthcare systems.
4. Stakeholder Management
   • Act as a liaison between business users, QA, and development teams.
   • Facilitate workshops, meetings, and requirement review sessions.
   • Ensure solutions align with both business goals and healthcare compliance requirements.
5. Testing & Validation
   • Assist in developing test cases and scenarios.
   • Validate system outputs with healthcare datasets.
   • Support UAT (User Acceptance Testing) with end-users.
6. Continuous Improvement
   • Recommend enhancements for efficiency, compliance, and patient/member satisfaction.
   • Stay updated on healthcare industry standards, technologies, and regulatory changes.

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