Business Analyst - Healthcare Interoperability & Data Integration
Location: Remote (EST Hours Required)
Preferred: Candidates located in or around Philadelphia are a plus, but NOT required.
Overview
We are seeking an experienced Business Analyst to support enterprise healthcare data exchange and interoperability initiatives within the Enterprise Data Office / Data Integration team. This role requires strong expertise in HL7 standards (FHIR, CCD, ADT, SIU), healthcare data integration, and regulatory interoperability requirements.
The ideal candidate will be a hands-on analyst who can independently gather requirements, perform data analysis, collaborate with technical teams, and drive successful delivery of healthcare data integration solutions.
Key Responsibilities
- Lead end-to-end requirements gathering, analysis, and documentation with business and technology stakeholders.
- Act as a subject matter expert for healthcare interoperability standards including FHIR, HL7, CCD, ADT, SIU, and CMS interoperability requirements.
- Translate business requirements into functional and technical specifications, process flows, business rules, and source-to-target mappings.
- Perform hands-on data analysis and validation using SQL, Databricks, and related data tools.
- Support testing and quality assurance activities, including review of test cases, data outputs, and validation results.
- Partner with internal teams and external vendors to support healthcare data exchange implementations.
- Document and analyze interoperability-related business processes and workflows.
- Collaborate with stakeholders across Healthcare Services, Claims, Enrollment, Quality/HEDIS, Risk Adjustment, Care Management, and Utilization Management.
- Facilitate discussions, drive consensus, and communicate recommendations to business and technology leadership.
- Provide regular project status updates, identify risks/issues, and support resolution efforts.
- Mentor junior Business Analysts and promote best practices in requirements management and documentation.
Required Qualifications
- 5+ years of experience as a Business Analyst supporting healthcare IT, healthcare data integration, or interoperability initiatives.
- Strong experience with FHIR, HL7, CCD, ADT, and SIU healthcare data exchange standards.
- Knowledge of healthcare data domains and terminology including ICD-10, CPT, LOINC, and related standards.
- Hands-on experience with SQL and data analysis/validation.
- Experience with Databricks or similar modern data platforms.
- Experience working within Agile teams using tools such as Azure DevOps or JIRA.
- Strong documentation skills, including business requirements, use cases, process flows, and data mapping.
- Knowledge of managed care processes including Claims, Enrollment, HEDIS, Prior Authorization, Care Management, and Risk Adjustment.
- Excellent communication, stakeholder management, and problem-solving skills.
- Ability to operate independently in a fast-paced, cross-functional environment.
- Bachelor's degree or equivalent combination of education and experience.
Preferred Qualifications
- Experience with CMS Interoperability, Healthcare Payer, or Managed Care organizations.
- Experience supporting enterprise data integration or interoperability programs.
- Prior experience working with healthcare vendors, provider systems, or EHR integrations.
- Philadelphia-area candidates preferred, though not required.
Additional Notes
- Remote-friendly position
- Candidates must be available to work EST business hours
- Strong preference for candidates with healthcare payer and interoperability experience
- FHIR/HL7 expertise is a core requirement