Healthcare Claims & AI-Driven Business Systems Analyst
Talent Groups
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Descrizione del lavoro
Talent Groups seeks a senior Business Analyst to elicit, analyze, and document complex business, operational, and system requirements in the Payment Integrity & Healthcare domain.
You translate business problems into functional requirements, workflows, process models, and user stories; define rules, signals, thresholds, and intervention logic; collaborate with SMEs and AI/DS teams to align on inputs, validation, and success metrics.
Competenze
- 10+ years of Business Analysis / Business Systems Analysis experience
- Strong U.S. Healthcare experience with all Lines of business
- Experience supporting AI, advanced analytics, or intelligent automation initiatives
- Healthcare claims processing and adjudication knowledge
- Knowledge of lifecycle of a claim is a “MUST”
Mansioni
- Elicit, analyze, and document complex business, operational, and system requirements
- Translate business problems into functional requirements, workflows, process models, and user stories
- Collaborate with SMEs to understand clinical and non-clinical claim scenarios
- Translate business risks and operational challenges into AI-ready business requirements
- Define business rules, signals, thresholds, and intervention logic for AI-enabled workflows
- Partner with Data Science teams to define model inputs, outputs, validation criteria, and success measures
- Strong senior BA leadership and stakeholder management to drive initiatives
Conoscenze
Descrizione del lavoro
Talent Groups seeks a senior Business Analyst to elicit, analyze, and document complex business, operational, and system requirements in the Payment Integrity & Healthcare domain.
You translate business problems into functional requirements, workflows, process models, and user stories; define rules, signals, thresholds, and intervention logic; collaborate with SMEs and AI/DS teams to align on inputs, validation, and success metrics.
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