Senior Healthcare Payer Business Analyst / Product Owner

Talent Software Services, Inc.

  • Minnetonka, MN
  • 3 days ago
  • $79.54–$83.33 Per Hour

Highlights

Support account teams in driving innovation by identifying relevant technology applications based on: Customer needs. Apply strong healthcare claims knowledge, including claims engines, product and benefits, and claim processing.

Numbers & Facts

LocationMinnetonka, MN
Salary$79.54–$83.33 Per Hour

Description

  • Location: Minnetonka Mills, MN
  • Duration: 6 months
  • Job Title: Senior Healthcare Payer Business Analyst / Product Owner
  • Experience Required: 6–8 years
  • Domain: Healthcare Payer
  • Role Summary:
    • Lead requirements gathering and drive consensus among multiple stakeholders.
    • Evaluate different stakeholder perspectives and align teams toward common business and technology goals.
    • Visualize and develop solutions that address business needs.
    • Create initial prototypes and proof-of-concepts (POCs).
    • Translate high-level business requirements into detailed solution requirements.
    • Support proactive solution pitches to healthcare payer business teams.
    • Align business objectives with IT strategies and lead internal IT teams.
    • Manage requirements within product backlogs.
    • Write detailed user stories, use cases, and acceptance criteria.
    • Support functional and acceptance testing activities.
    • Evangelize solutions and secure stakeholder buy-in.
    • Demonstrate 10+ years of hands-on healthcare payer experience.
    • Apply strong healthcare claims knowledge, including claims engines, product and benefits, and claim processing.
    • Demonstrate broad understanding of healthcare payer functions, including:
      • Sales and Marketing
      • Healthcare Product Management
      • Membership
      • Provider Management
      • Prior Authorization
      • Utilization Management
      • Claims
      • Program Integrity
    • Understand healthcare lines of business such as Medicare and Medicaid.
    • Maintain awareness of CMS guidelines and healthcare industry trends.
    • Apply strong communication, influencing, analytical, and leadership skills.
    • Write SMART requirements that are Specific, Measurable, Accurate, Realistic, and Time-bound.
  • Product Owner Experience:
    • Manage and prioritize product backlogs.
    • Write detailed user stories and use cases.
    • Define acceptance criteria and functional requirements.
    • Plan and support program increments and sprints.
    • Coordinate with development and business teams to ensure successful delivery.
    • Drive teams toward demonstrable and showcase-ready solutions.
  • Responsibilities & Expectations:
    • Develop points of view (POVs) on topics relevant to client business needs.
    • Monitor regulatory changes, industry drivers, and healthcare trends.
    • Develop contextual POVs, articles, and blogs based on industry developments.
    • Collaborate with data scientists, AI architects, and technical teams to rapidly develop solutions and POCs.
    • Write detailed use cases with minimal guidance or dependency.
    • Support account teams in driving innovation by identifying relevant technology applications based on:
      • Customer needs
      • AI maturity
      • Current business requirements
      • Target audience and stakeholder roles
    • Stay current with healthcare industry trends, including:
      • Interoperability
      • FHIR
      • HL7
      • EDI
      • Cost of Care
      • Value-Based Care
    • Understand evolving healthcare business models and industry drivers.
    • Apply emerging technologies such as AI and Generative AI to real-world healthcare business problems.
    • Demonstrate a deep understanding of the healthcare ecosystem and value chains.
    • Understand value exchange between healthcare entities.
    • Quickly understand adjacent healthcare domains, including:
      • Pharmacy
      • Pharmacy Dispensing
      • Pharmacy Benefit Management (PBM)
    • Identify innovative aspects of solutions and contribute to intellectual property opportunities, including patents, copyrights, and trademarks.
  • Healthcare Domain Expertise:
    • Healthcare Payer
    • Healthcare Claims
    • Claims Engines
    • Product & Benefits
    • Claims Processing
    • Medicare
    • Medicaid
    • CMS Guidelines
    • Membership
    • Providers
    • Prior Authorization
    • Utilization Management
    • Program Integrity
    • Pharmacy
    • PBM
    • Healthcare Product Management
    • Value-Based Care
    • Cost of Care
    • Healthcare Interoperability
  • AI & Technology Skills:
    • Artificial Intelligence (AI)
    • Generative AI
    • AI Solution Development
    • AI/POC Development
    • Collaboration with Data Scientists
    • AI Architecture
    • Technology Solutioning
    • Prototyping
    • Proof of Concepts
  • Interoperability Skills:
    • FHIR
    • HL7
    • EDI
    • Healthcare Data Exchange
    • Healthcare Interoperability
  • Essential Skills:
    • Business Analysis
    • Healthcare Payer
    • Healthcare Claims
    • Healthcare Product & Benefits
    • Product Owner Experience
    • Requirements Management
    • User Stories
    • Use Cases
    • Product Backlog Management
    • Acceptance Testing
    • Functional Testing
    • Stakeholder Management
    • Consensus Building
    • Solution Design
    • Healthcare Domain Expertise
    • AI / Generative AI
  • Key Competencies:
    • Strong communication and influencing skills.
    • Strong analytical and problem-solving abilities.
    • Ability to drive cross-functional teams.
    • Ability to translate business needs into actionable technical solutions.
    • Ability to manage complex stakeholder requirements.
    • Strong presentation and solution evangelization skills.
    • Ability to create SMART requirements.
    • Strong understanding of healthcare payer business models and processes.
    • Ability to work independently with minimal guidance.

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