Note: The job is a remote job and is open to candidates in USA. OwlSure provides solutions and services to Financial Services, Healthcare, and Life Insurance organizations to improve budget value, speed-to-market, and operational scale. The Lead Business Systems Analyst will lead requirements for interoperability and electronic prior authorization initiatives, coordinate with vendors and cross-functional teams, analyze FHIR and healthcare data exchange workflows, and manage testing and readiness activities.
Responsibilities
- Own end-to-end business and functional requirements for ePA, CRD, DTR, and PAS
- Facilitate requirement sessions across business, operations, and technology teams
- Translate regulatory requirements into business and technical requirements
- Maintain requirements traceability from CMS regulations through implementation and testing
- Act as primary day-to-day requirements lead with Vendor Management
- Review vendor assumptions, solution designs, workflows, and implementation approaches
- Track gaps, risks, dependencies, and open decisions
- Understand CRD, DTR, PAS, Patient Access, Provider Access, and Payer-to-Payer workflows
- Analyze FHIR resource requirements and data mapping needs
- Partner with API teams on business workflow impacts
- Define business test scenarios
- Coordinate end-to-end testing
- Validate provider workflows
Skills
- • 8+ years as BSA/Product Owner/Product Manager
- • Healthcare payer experience
- • Prior Authorization experience
- • Vendor management experience
- • API integration experience
- • Strong facilitation and stakeholder management skills
- • FHIR
- • CMS-0057-F
- • CRD/DTR/PAS
- • HL7
- • Interoperability programs
- • Utilization Management workflows
- • Medical Policy systems
Benefits
- Remote work option in New Jersey or remotely
- Contract-to-hire employment arrangement
Company Overview
Company H1B Sponsorship