Senior Healthcare Business Analyst

Overview

Remote
Full Time
Part Time
Accepts corp to corp applications
Contract - W2
Contract - Independent

Job Details

This is Sai Vikas from Tek Leaders. One of our client is looking for Healthcare Business Analyst @ Cincinnati, OH. you can reach me at

Role: Senior Healthcare Business Analyst (Healthcare payer, Healthcare provider )

Location: Remote

Collaborate with AI engineers and data engineers to align AI outputs with business goals | Ensure ethical and responsible AI practices in solution deployment and stakeholder communication | AI Functional Consulting and Data Strategy



Skill Matrix


Skills

Years of Exp

Year lastly Used

Rating Out of 10

Healthcare Business Analyst

Healthcare payer

Healthcare provider

AI models (AI/ML)

BI Tools

Job Description:

  • Domain-Specific Skills - Payer Space Solid understanding of the healthcare payer ecosystem, including member services, provider interactions, claims lifecycle, and care management workflows.
  • Ability to interpret and work with payer data structures, such as enrollment, eligibility, claims, and utilization data. Experience supporting initiatives related to cost optimization, member engagement, and operational efficiency within payer organizations.
  • Familiarity with industry trends such as value-based care, digital health transformation, and AI-driven analytics in payer operations. Ability to identify and define AI use cases that align with payer business goals - such as improving decision support, enhancing data visibility, and enabling predictive insights.
  • Understanding of stakeholder dynamics in payer organizations, including collaboration across business, clinical, and IT teams. Exposure to healthcare analytics platforms and tools commonly used in payer environments.
  • AI Functional Consulting & Data Strategy Act as the AI evangelist for SmartPlan Insights, translating AI capabilities into business value.
  • Understand and explain AI models and features used in the platform (RAG, Semantics, Ontology, LLMs, Chunking, Embedding etc.)
  • Collaborate with AI engineers and data engineers to align AI outputs with business goals.
  • Identify and define new AI use cases for performance analysis, forecasting, and strategic planning.
  • Ensure ethical and responsible AI practices in solution deployment and stakeholder communication.
  • Domain-Specific Skills - Payer Space Solid understanding of the healthcare payer ecosystem, including member services, provider interactions, claims lifecycle, and care management workflows.
  • Ability to interpret and work with payer data structures, such as enrollment, eligibility, claims, and utilization data.
  • Experience supporting initiatives related to cost optimization, member engagement, and operational efficiency within payer organizations.
  • Ability to identify and define AI use cases that align with payer business goals - such as improving decision support, enhancing data visibility, and enabling predictive insights.
  • Understanding of stakeholder dynamics in payer organizations, including collaboration across business, clinical, and IT teams.
  • Exposure to healthcare analytics platforms and tools commonly used in payer environments. Customer Engagement & Stakeholder Management

Required Skills & Qualifications:

12+ years of experience in business analysis,

  • functional consulting, and customer-facing roles. Strong understanding of AI/ML concepts, including LLMs, RAG, NLP, UX strategy and data modeling.
  • Experience working with AI platforms, BI tools, and data visualization frameworks. Familiarity with data pipelines, and AI lifecycle management.
  • Excellent communication, facilitation, and stakeholder management skills.
  • Ability to work independently and drive initiatives with minimal supervision.
  • Prior experience in healthcare payer, healthcare provider, HealthTech or healthcare analytics is a plus.
  • Familiarity with methodologies and tools for application lifecycle management.
  • Preferred Attributes: Strategic thinker with a consultative mindset. Passion for innovation and emerging technologies. Comfortable navigating ambiguity and driving clarity. Collaborative and empathetic approach to customer engagement.

Thanks & Regards

Sai vikas Vemula

Sr IT recruiter

Email ID:

5151 Headquarters Dr.Suite: 105, Plano, TX 75024.

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