Lead Business Analyst

🔍 Hiring: Lead Business Analyst – CMS Interoperability & FHIR 📍 Location: Bengaluru / Chennai / Remote ⏳ Duration: Contract (6 Months) 🏥 Domain: Healthcare Payer | Interoperability 🚀 Start: Immediate / Early April We are looking for an experienced Lead Business Analyst with strong expertise in CMS‑0057‑F Final Rule, FHIR APIs, and Utilization Management (UM) to support a high‑visibility payer interoperability initiative. 🧠 What You’ll Do Analyze CMS‑0057‑F Final Rule and CMS guidance to define payer obligations, timelines, and reporting needs Translate regulatory language into business requirements, functional requirements, and acceptance criteria Act as the functional SME for Utilization Management (UM) across ANG / Atrezzo platforms Define and document FHIR R4 resource requirements (Coverage, Claim, ClaimResponse, PriorAuthorization, Questionnaire, DocumentReference) Work on Patient Access, Provider Access, and Payer‑to‑Payer APIs Support FHIR‑based Prior Authorization APIs, including decisions, status, and clinical documentation exchange Create and maintain a Regulatory Traceability Matrix (RTM) Document current‑state and future‑state UM workflows (intake, review, decision, notifications) Identify system gaps and define configuration vs customization needs Collaborate with architects and developers to align with CMS specs and IGs (Da Vinci, CARIN) ✅ What We’re Looking For 8+ years of experience as a Business Analyst in healthcare payer systems Hands‑on experience with CMS‑0057‑F or CMS Interoperability regulations Strong knowledge of FHIR / HL7 FHIR (FHIR R4) Solid experience in Prior Authorization & Utilization Management (UM) Experience with ANG / Atrezzo (highly preferred) Understanding of FHIR APIs and interoperability workflows Excellent documentation, stakeholder communication, and leadership skills 🌟 Nice to Have Experience with Da Vinci or CARIN Implementation Guides Prior involvement in payer compliance or interoperability programs Agile / Scrum environment exposure 📩 Interested? share your updated CV on [Upgrade to PRO to see contact] Referrals are welcome! #Hiring #BusinessAnalyst #CMS0057F #FHIR #HealthcareIT #Interoperability #PriorAuthorization #UtilizationManagement #PayerSystems #Atrezzo #ANG