Healthcare Business Analyst

Role Summary We are seeking an experienced Healthcare Business Analyst with strong hands-on experience in Electronic Prior Authorization (ePA), CMS-0057, FHIR, and healthcare interoperability. The candidate should be able to work directly with clients, partners, product, and technical teams and contribute quickly to complex healthcare implementations.

Key Responsibilities

Gather, analyze, and document business and functional requirements for ePA and FHIR-based solutions. Support CMS-0057 requirements, including Patient Access, Provider Access, Payer-to-Payer, and Prior Authorization APIs. Understand end-to-end ePA workflows, including CRD, DTR, and PAS, and how Onyx workflows fit into the process. Read and interpret FHIR Implementation Guides, including Da Vinci, CARIN, and PDex. Convert business scenarios into BRDs, functional requirements, user stories, acceptance criteria, workflow diagrams, and UAT scenarios. Work with clients, healthcare partners, product, development, and QA teams to clarify requirements and drive decisions. Participate in Agile ceremonies including backlog refinement, sprint planning, and requirement walkthroughs. Required Skills 5+ years of experience as a Healthcare Business Analyst. Hands-on ePA / Prior Authorization experience. Strong understanding of CMS-0057 and Prior Authorization APIs. Strong working knowledge of FHIR, HL7, and healthcare interoperability. Experience with CRD, DTR, and PAS. Ability to work with FHIR Implementation Guides Da Vinci, CARIN, PDex. Understanding of healthcare code sets/terminologies. Strong experience creating BRDs, requirements, user stories, UAT scenarios, and process flows. Experience with Jira / Azure DevOps and Agile/Scrum. Strong client and stakeholder communication skills with the ability to drive discussions to decisions. Preferred Payer/provider or utilization management experience. FHIR API / Postman experience. SQL or Python knowledge.