Business Analyst – Healthcare Interoperability

Photon; United States; On-site; USD 130,000 - 180,000; Full time

Job summary

Photon is seeking a Senior Healthcare Business Analyst to drive data exchange initiatives for Health100, our AI-native healthcare platform. You will bridge clinical needs with technical implementation and lead analysis, mapping, and implementation of interoperability standards.

You'll oversee data governance, privacy compliance (HIPAA, CARIN), and real-time data ingestion using FHIR R4, HL7 v2/v3, and CCDA to FHIR transformations, collaborating with data engineering, cloud architects, and AI

Qualifications

• 5+ years of Business Analyst experience in healthcare, health insurance, or health-tech domains.
• Strong hands-on understanding of interoperability standards: FHIR R4, HL7 v2/v3, and CCDA to FHIR.
• Regulatory knowledge of CMS/ONC Interoperability rules, TEFCA, and CARIN consumer guidelines.
• Experience with API testing tools (Postman/Insomnia), payload formats (JSON/XML), and SQL validation.
• Agile/Scrum experience using Jira and Confluence.

Responsibilities

• Lead data mapping initiatives for CCDA to FHIR, HL7 v2/v3 to FHIR, and proprietary formats.
• Ensure adherence to HL7 FHIR R4 / SMART on FHIR standards for real-time data ingestion and workflows.
• Oversee data governance, privacy compliance, and secure consent frameworks across platforms.

Skills

Data mapping

FHIR/HL7 interoperability

Healthcare data standards

Regulatory compliance

Agile Scrum

SQL queries

Tools

Postman

Insomnia

Jira

Confluence

BigQuery

Cloud Healthcare API

Job description

For the past 20 years, we have powered many Digital Experiences for the Fortune 500. Since 1999, we have grown from a few people to more than 4000 team members across the globe that are engaged in various Digital Modernization. Our current focus and innovation in Digital Hyper expansion TM offers nearly limitless opportunities for career growth. For a brief 1-minute video about us, you can check out https://youtu.be/uJWBWQZEA6o.

Photon is an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. We bring out the best in each other.

Job Description: Business Analyst – Healthcare Interoperability & Health100 Platform

Role Overview

We are seeking a Senior Healthcare Business Analyst to join our Digital Technology division, driving key data exchange initiatives for Health100—our AI-native healthcare engagement platform and ecosystem.

In this role, you will bridge the gap between clinical/operational needs and technical implementation for Health100.You will lead the analysis, mapping, and implementation of healthcare data exchange protocols, ensuring seamless interoperability across systems using FHIR, HL7 v2/v3, and C-CDA to FHIR transformations. Your technical depth in healthcare standards combined with strong analytical capabilities will drive the design of

scalable data workflows for AI-driven healthcare solutions.

Key Responsibilities

• Lead data mapping initiatives, specifically defining transformational rules for CCDA to FHIR, HL7 v2/v3 to FHIR, and proprietary clinical formats.
• Ensure strict adherence to HL7 FHIR R4 / SMART on FHIR standards for real-time patient data ingestion, cost transparency tools, and pharmacy engagement workflows.
• Oversee data governance, privacy compliance (CARIN Code of Conduct for Consumer-Facing Applications, HIPAA), and secure consent management frameworks across consumer data-sharing platforms.

Requirements Analysis

• Gather, document, and refine business and functional requirements for integration into the CVS Health100™ platform.
• Conduct gap analysis between legacy core systems (EHRs, pharmacy operating systems, claims processing platforms) and modern FHIR-based APIs.

Cross-Functional Collaboration & Execution

• Collaborate with third-party digital health partners, health plans, and provider organizations integrating into the Health100™ open ecosystem.
• Partner closely with data engineering, cloud software architects, and AI developers working with Google Cloud technologies (BigQuery, Cloud Healthcare API, Gemini models) to build real-time clinical workflows.
• Design and execute end-to‑end User Acceptance Testing (UAT), including sample payload generation (JSON/XML) and validating output data integrity.

Required Qualifications

• Experience: 5+ years of Business Analyst experience in the healthcare, health insurance (payer), or health-tech domains.
• Interoperability Standards Expertise: Strong hands-on understanding of key standards:
• FHIR: FHIR R4 resources (Patient, Encounters, Diagnostic Report,MedicationRequest, Observation, Service Requests etc), SMART on FHIR, and profile extensions.
• C-CDA: Clinical Document Architecture parsing, data mapping techniques, and CCDA FHIR conversion workflows.
• Regulatory Knowledge: Deep understanding of the CMS/ONC Interoperability and Patient Access Final Rules, TEFCA, and CARIN Alliance consumer access guidelines.
• Technical Skills: Experience with API testing tools (Postman, Insomnia), payload formats (JSON, XML), and SQL querying capabilities for data validation.
• Agile Delivery: Proven experience in Agile/Scrum environments using tools like Jira and Confluence