Healthcare Business Analyst(15+ yrs)

Job Title: Business Analyst Healthcare Domain
Location: Irving, TX
Experience Level: 12+ Years

About the Role:
We are seeking an experienced Business Analyst with strong healthcare domain expertise to join our team. The ideal candidate will bridge the gap between business stakeholders and technology teams, ensuring solutions align with business needs, regulatory requirements, and industry best practices.

Key Responsibilities:
Collaborate with business stakeholders, product owners, and technical teams to gather, analyze, and document business requirements.
Work on healthcare-related projects such as EHR/EMR systems, claims processing, eligibility, enrollment, care management, and provider/payer solutions.
Translate business needs into functional specifications, user stories, process flows, and use cases.
Facilitate requirements workshops, interviews, and joint application design (JAD) sessions.
Partner with QA teams to define test cases and ensure requirements traceability.
Support UAT (User Acceptance Testing) by coordinating with stakeholders and validating delivered solutions.
Ensure compliance with healthcare regulations such as HIPAA, HITECH, and CMS guidelines.
Perform gap analysis, impact analysis, and recommend process improvements.
Act as a liaison between business and IT to resolve issues and ensure project success.

Required Qualifications:
Bachelor s degree in Business Administration, Healthcare Management, Computer Science, or related field.
10+ years of experience as a Business Analyst, with at least 3 years in the healthcare domain (payer, provider, or healthcare IT).
Strong knowledge of healthcare processes such as claims adjudication, member enrollment, billing, coding (ICD, CPT, HCPCS), and healthcare data exchange (HL7, EDI, FHIR).
Proficiency in tools such as JIRA, Confluence, MS Visio, Excel, or similar.
Experience with Agile and/or Waterfall methodologies.
Excellent communication, analytical, and stakeholder management skills.

Preferred Qualifications:
Experience with Medicare/Medicaid, PBM, or population health management systems.
Familiarity with SQL or data analysis for validating reports and healthcare datasets.
Certifications such as CBAP, CCBA, CSM, or SAFe.
Prior experience working with large-scale healthcare transformation projects.

Soft Skills:
Strong problem-solving and critical thinking skills.
Ability to work independently and collaboratively in cross-functional teams.
Adaptability to fast-paced and evolving environments.