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Mid-level BA title, metro location, and common skillset increase candidate competition.
Deep payer and regulatory requirements (HIPAA, CMS, FHIR) make skills less transferable across industries.
Explicit 4–7 years, domain-specific payer expertise, and mandatory technical skills raise filtering strictness.
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Lead requirements gathering, process mapping, and data analysis for healthcare payer projects (claims processing, provider networks, member engagement).
Ensure solutions comply with healthcare payer regulations (HIPAA, CMS) and align with value-based care models, delivering measurable client value.
Mentor junior analysts and champion business analysis best practices within the team.
4 to 7 years of experience as a Business Analyst with healthcare payer domain expertise.
Strong skills in requirements elicitation and documentation using tools like JIRA and Azure DevOps.
Proficient in process modeling (BPMN, Visio) and data analysis with advanced SQL and data visualization tools (Tableau, Power BI).
Knowledge of healthcare payer regulations (HIPAA, ACA, CMS) and technical understanding of API concepts and system integration.
Experienced in bridging complex healthcare payer business needs with technology solutions, specifically in claims, enrollment, provider networks, and benefits.
Capable of managing diverse stakeholders and communicating complex regulatory and technical concepts clearly.
Skilled in designing solutions that comply with payer regulations and support digital transformation in healthcare payer operations.