Life Sciences Business Architect

Overview

On Site
Full Time
Part Time
Accepts corp to corp applications
Contract - W2
Contract - Independent
Contract - 5 day((s))

Skills

Business Architect

Job Details

Role: Life Sciences Business Architect / Domain Consultant
Experience: 7 12 Years
Location:Valencia, CA

Overview:
We're looking for an experienced professional with strong expertise in the Pre-Authorization (Pre-Auth) space within Life Sciences and Healthcare. The role involves advising clients, analyzing processes, and designing digital solutions to optimize pre-auth workflows and patient access.

Key Responsibilities:

  • Act as a Subject Matter Expert (SME) in pre-authorization workflows (medical necessity, clinical documentation, payer provider interactions).

  • Analyze current processes and design target operating models for pre-auth transformation.

  • Collaborate with tech teams to design and implement digital/AI-based pre-auth solutions.

  • Ensure compliance with CMS, FDA, and global regulations.

  • Lead client workshops and define KPIs to improve efficiency and patient experience.

Required Skills:

  • 7 12 years in Life Sciences, Healthcare, or Payer/Provider domains (with 3 5 years in Pre-Auth or Utilization Management).

  • Deep understanding of prior authorization workflows, interoperability (HL7 FHIR, X12, NCPDP), and clinical guidelines.

  • Hands-on experience with EHR, claims, and benefit management systems.

  • Excellent consulting, business analysis, and stakeholder management skills.

Preferred:

  • Knowledge of CMS interoperability mandates and Life Sciences value chain.

  • Exposure to AI/automation use cases in pre-auth.

  • MBA or advanced degree in Life Sciences/Healthcare preferred.

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