Lumenalta
Business Analyst – Healthcare (Remote – U.S.)
Join Lumenalta to apply for this remote Business Analyst – Healthcare role, shaping digital transformation across the U.S. healthcare landscape.
Base pay range: $90,000 – $120,000 annually. Location: United States (W2). This is a full‑time position requiring 40 hours per week Monday through Friday.
Who You Are
You have a deep understanding of the U.S. healthcare system, particularly Medicaid and Medicare programs, payer operations, and provider networks.
You excel at bridging the gap between business and technology, translating healthcare policy, data, and process requirements into clear documentation and delivery plans.
You thrive in environments that require precision, empathy, and regulatory awareness—where the work you do directly impacts the accessibility, affordability, and quality of care.
You are detail‑oriented, analytical, and proactive—able to identify opportunities for optimization while ensuring compliance with CMS, HIPAA, and state‑specific healthcare regulations.
You collaborate seamlessly across technical, business, and clinical stakeholders, ensuring every voice is heard and every requirement is well‑defined.
What You’ll Do
Requirements Gathering & Analysis: Partner with clients and internal teams to understand, document, and validate business needs across Medicaid, Medicare, and payer/provider operations.
Process Mapping & Optimization: Analyze current‑state workflows (e.g., claims processing, eligibility and enrollment, provider data management) and define future‑state solutions.
Documentation: Develop detailed business requirements, functional specifications, and user stories that guide design and delivery teams.
Regulatory Compliance: Ensure all requirements and proposed solutions align with federal and state healthcare regulations, CMS standards, HIPAA, and interoperability mandates.
Stakeholder Collaboration: Facilitate discussions between product delivery, engineering, QA, and client teams, ensuring clarity, alignment, and smooth execution.
Data & Systems Analysis: Work with data teams to validate data flows, mappings, and integration points across systems (EHR, EMR, claims, and analytics platforms).
Testing Support: Collaborate with QA teams to develop test cases and acceptance criteria that validate business requirements and ensure successful user acceptance testing (UAT).
Change Management: Support organizational change efforts by creating clear documentation, process training, and communication materials for end users.
Continuous Improvement: Identify opportunities for efficiency, cost reduction, and improved user experience across healthcare delivery processes.
Key Qualifications
5–10 years of experience as a Business Analyst or Product Analyst in healthcare technology, consulting, or payer/provider organizations.
Strong understanding of Medicaid and Medicare program operations, payer workflows, and healthcare data systems.
Experience working with EHR/EMR, claims processing, eligibility & enrollment systems, and data integration projects.
Proven ability to manage requirements across complex, multi‑stakeholder projects within regulated environments.
Familiarity with CMS frameworks, HIPAA, and healthcare interoperability standards (e.g., HL7, FHIR).
Strong analytical, problem‑solving, and communication skills with the ability to translate technical details into business language.
Experience with Agile or hybrid delivery methodologies and tools such as JIRA, Confluence, or Azure DevOps.
Bachelor’s degree in Business, Healthcare Administration, Information Systems, or a related field.
Experience interpreting healthcare data structures, including claims, eligibility, and encounter data.
Familiarity with SQL, BI tools, or data visualization platforms (e.g., Power BI, Tableau) is an asset.
Ability to work effectively with delivery teams on data mapping, validation, and transformation logic.
Location Requirements
Candidates must be located within the United States (W2)
Benefits
Flexible working hours in a remote environment.
Health insurance (medical and dental) for W2 Employees.
401(k) Contribution.
A professional development fund to enhance your skills and knowledge.
15 days of paid time off annually.
Access to soft‑skill development courses to further your career.
Employment Type Full‑time
Seniority Level Mid‑Senior level
Job Function Engineering, Information Technology, and Consulting
#J-18808-Ljbffr
Who You Are
You have a deep understanding of the U.S. healthcare system, particularly Medicaid and Medicare programs, payer operations, and provider networks.
You excel at bridging the gap between business and technology, translating healthcare policy, data, and process requirements into clear documentation and delivery plans.
You thrive in environments that require precision, empathy, and regulatory awareness—where the work you do directly impacts the accessibility, affordability, and quality of care.
You are detail‑oriented, analytical, and proactive—able to identify opportunities for optimization while ensuring compliance with CMS, HIPAA, and state‑specific healthcare regulations.
You collaborate seamlessly across technical, business, and clinical stakeholders, ensuring every voice is heard and every requirement is well‑defined.
What You’ll Do
Requirements Gathering & Analysis: Partner with clients and internal teams to understand, document, and validate business needs across Medicaid, Medicare, and payer/provider operations.
Process Mapping & Optimization: Analyze current‑state workflows (e.g., claims processing, eligibility and enrollment, provider data management) and define future‑state solutions.
Documentation: Develop detailed business requirements, functional specifications, and user stories that guide design and delivery teams.
Regulatory Compliance: Ensure all requirements and proposed solutions align with federal and state healthcare regulations, CMS standards, HIPAA, and interoperability mandates.
Stakeholder Collaboration: Facilitate discussions between product delivery, engineering, QA, and client teams, ensuring clarity, alignment, and smooth execution.
Data & Systems Analysis: Work with data teams to validate data flows, mappings, and integration points across systems (EHR, EMR, claims, and analytics platforms).
Testing Support: Collaborate with QA teams to develop test cases and acceptance criteria that validate business requirements and ensure successful user acceptance testing (UAT).
Change Management: Support organizational change efforts by creating clear documentation, process training, and communication materials for end users.
Continuous Improvement: Identify opportunities for efficiency, cost reduction, and improved user experience across healthcare delivery processes.
Key Qualifications
5–10 years of experience as a Business Analyst or Product Analyst in healthcare technology, consulting, or payer/provider organizations.
Strong understanding of Medicaid and Medicare program operations, payer workflows, and healthcare data systems.
Experience working with EHR/EMR, claims processing, eligibility & enrollment systems, and data integration projects.
Proven ability to manage requirements across complex, multi‑stakeholder projects within regulated environments.
Familiarity with CMS frameworks, HIPAA, and healthcare interoperability standards (e.g., HL7, FHIR).
Strong analytical, problem‑solving, and communication skills with the ability to translate technical details into business language.
Experience with Agile or hybrid delivery methodologies and tools such as JIRA, Confluence, or Azure DevOps.
Bachelor’s degree in Business, Healthcare Administration, Information Systems, or a related field.
Experience interpreting healthcare data structures, including claims, eligibility, and encounter data.
Familiarity with SQL, BI tools, or data visualization platforms (e.g., Power BI, Tableau) is an asset.
Ability to work effectively with delivery teams on data mapping, validation, and transformation logic.
Location Requirements
Candidates must be located within the United States (W2)
Benefits
Flexible working hours in a remote environment.
Health insurance (medical and dental) for W2 Employees.
401(k) Contribution.
A professional development fund to enhance your skills and knowledge.
15 days of paid time off annually.
Access to soft‑skill development courses to further your career.
Employment Type Full‑time
Seniority Level Mid‑Senior level
Job Function Engineering, Information Technology, and Consulting
#J-18808-Ljbffr