- Good understanding of Healthcare reforms and regulatory frameworks, including Medicaid and CMS requirements
- In-depth knowledge of encounter processing, Medicare, Medicaid and ACA lines of business
- Ability to analyze CMS requirements for encounter submissions and document related product features and functionalities
- Strong understanding with CMS risk adjustment models (e.g., HCC, HHS, CDPS)
- Excellent communication skills with the ability to effectively interface with technical teams, clinical stakeholders and customers
- Strong documentation skills with great attention to detail
- Experience working in Agile/Scrum environment, including participation in sprint planning and grooming sessions
- Ability to interpret business and technical requirements and translate them into functional specifications
- Strong problem-solving and product management skills, with a clear understanding of how to interpret business needs and translate them into application and operational requirements
- Experience in test planning, and conducting user acceptance testing for large enterprise systems
- Familiarity with company policies and procedures and the ability to apply them effectively
- Experience with clinical workflows and AI/NLP-based solutions is a plus
- Bachelor’s or Master’s degree in Computer Science, Business Administration, or a related field; Certification in Business Analysis (CBAP) is a plus.
- 4-5 years’ experience as a Business Analyst/ Systems Analyst, Product Owner or in a similar role within a healthcare technology environment
Desired Skills:
- Understanding of CMS regulations, coding guideline updates, and healthcare compliance standards
- Exposure to provider workflows, coding and revenue cycle processes
- Experience managing requirements development and collaborating with engineering teams to ensure successful execution
We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, sex, religion, national origin, protected veteran status, disability status, or any other characteristic protected by law.