Robotics Prcocess Automation, LLC
Business Analyst/Project Manager
Robotics Prcocess Automation, LLC, Villa Espana Colonia, Texas, United States
We are seeking an experienced Domain Consultant
with deep expertise in the Pre-Authorization (Pre-Auth) space within Life Sciences and Healthcare . The ideal candidate will bring a strong understanding of payer, provider, and life sciences ecosystems, including regulatory frameworks, utilization management, patient access, and digital transformation trends. This role will combine domain knowledge, client advisory, and solution design to drive strategic engagements for pharmaceutical, biotech, and med-tech clients.
Key Responsibilities
Act as a subject matter expert (SME)
in pre-authorization workflows, covering medical necessity, clinical documentation, prior authorization rules, and payer–provider interactions.
Support clients in transforming pre-auth processes
to improve speed, compliance, and patient experience.
Analyze existing business processes, identify gaps, and design target operating models
for pre-auth.
Partner with technology teams to shape digital and GenAI solutions
(e.g., automated prior authorization, real-time benefit checks, interoperability with EMR/EHR).
Advise on compliance with CMS, FDA, and global regulations
around pre-authorization, patient safety, and access.
Collaborate with product managers, architects, and delivery teams to ensure
business requirements are translated into solution designs .
Conduct
workshops with client stakeholders
to gather business requirements, define KPIs, and build consensus.
Contribute to thought leadership
(white papers, PoVs, webinars) on pre-auth trends and innovation in life sciences.
Required Skills & Experience
7–12 years of domain experience
in Life Sciences, Healthcare, or Payer/Provider organizations, with at least
3–5 years focused on pre-authorization or utilization management .
Strong knowledge of:
Prior authorization workflows (medical and pharmacy benefits)
Interoperability standards (HL7 FHIR, X12, NCPDP)
Clinical guidelines and evidence-based medical policy
Patient access and affordability challenges
Exposure to
payer and provider systems
(EHR, claim processing, benefit management).
Experience in consulting or business analysis
roles, preferably with global clients.
Proven ability to
liaise between business and technology teams .
Excellent communication, presentation, and stakeholder management skills.
Preferred Qualifications
Experience with
CMS interoperability mandates
(e.g., CMS-0057-F, PA APIs).
Knowledge of
life sciences value chain
(pharma/biotech market access, hub services, patient support programs).
Familiarity with
AI/ML and automation use cases
in pre-auth and utilization management.
Prior experience in a
consulting firm or digital transformation environment .
Bachelor’s or Master’s degree in
Life Sciences, Healthcare Management, Pharmacy, or related field ; MBA preferred.
ROBOTIC PROCESS AUTOMATION LLC is an equal opportunity employer inclusive of female, minority, disability and veterans, (M/F/D/V). Hiring, promotion, transfer, compensation, benefits, discipline, termination and all other employment decisions are made without regard to race, color, religion, sex, sexual orientation, gender identity, age, disability, national origin, citizenship/immigration status, veteran status or any other protected status. ROBOTIC PROCESS AUTOMATION LLC will not make any posting or employment decision that does not comply with applicable laws relating to labor and employment, equal opportunity, employment eligibility requirements or related matters. Nor will ROBOTIC PROCESS AUTOMATION LLC require in a posting or otherwise U.S. citizenship or lawful permanent residency in the U.S. as a condition of employment except as necessary to comply with law, regulation, executive order, or federal, state, or local government contract
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with deep expertise in the Pre-Authorization (Pre-Auth) space within Life Sciences and Healthcare . The ideal candidate will bring a strong understanding of payer, provider, and life sciences ecosystems, including regulatory frameworks, utilization management, patient access, and digital transformation trends. This role will combine domain knowledge, client advisory, and solution design to drive strategic engagements for pharmaceutical, biotech, and med-tech clients.
Key Responsibilities
Act as a subject matter expert (SME)
in pre-authorization workflows, covering medical necessity, clinical documentation, prior authorization rules, and payer–provider interactions.
Support clients in transforming pre-auth processes
to improve speed, compliance, and patient experience.
Analyze existing business processes, identify gaps, and design target operating models
for pre-auth.
Partner with technology teams to shape digital and GenAI solutions
(e.g., automated prior authorization, real-time benefit checks, interoperability with EMR/EHR).
Advise on compliance with CMS, FDA, and global regulations
around pre-authorization, patient safety, and access.
Collaborate with product managers, architects, and delivery teams to ensure
business requirements are translated into solution designs .
Conduct
workshops with client stakeholders
to gather business requirements, define KPIs, and build consensus.
Contribute to thought leadership
(white papers, PoVs, webinars) on pre-auth trends and innovation in life sciences.
Required Skills & Experience
7–12 years of domain experience
in Life Sciences, Healthcare, or Payer/Provider organizations, with at least
3–5 years focused on pre-authorization or utilization management .
Strong knowledge of:
Prior authorization workflows (medical and pharmacy benefits)
Interoperability standards (HL7 FHIR, X12, NCPDP)
Clinical guidelines and evidence-based medical policy
Patient access and affordability challenges
Exposure to
payer and provider systems
(EHR, claim processing, benefit management).
Experience in consulting or business analysis
roles, preferably with global clients.
Proven ability to
liaise between business and technology teams .
Excellent communication, presentation, and stakeholder management skills.
Preferred Qualifications
Experience with
CMS interoperability mandates
(e.g., CMS-0057-F, PA APIs).
Knowledge of
life sciences value chain
(pharma/biotech market access, hub services, patient support programs).
Familiarity with
AI/ML and automation use cases
in pre-auth and utilization management.
Prior experience in a
consulting firm or digital transformation environment .
Bachelor’s or Master’s degree in
Life Sciences, Healthcare Management, Pharmacy, or related field ; MBA preferred.
ROBOTIC PROCESS AUTOMATION LLC is an equal opportunity employer inclusive of female, minority, disability and veterans, (M/F/D/V). Hiring, promotion, transfer, compensation, benefits, discipline, termination and all other employment decisions are made without regard to race, color, religion, sex, sexual orientation, gender identity, age, disability, national origin, citizenship/immigration status, veteran status or any other protected status. ROBOTIC PROCESS AUTOMATION LLC will not make any posting or employment decision that does not comply with applicable laws relating to labor and employment, equal opportunity, employment eligibility requirements or related matters. Nor will ROBOTIC PROCESS AUTOMATION LLC require in a posting or otherwise U.S. citizenship or lawful permanent residency in the U.S. as a condition of employment except as necessary to comply with law, regulation, executive order, or federal, state, or local government contract
#J-18808-Ljbffr