Technical BA-Healthcare Data Interoperability (Pune, India)

Abacus Insights is a mission-driven, growth-stage technology company focused on transforming the healthcare industry, ultimately creating a more personalized patient experience, improving health outcomes, and lowering the overall cost of healthcare. Abacus Insights provides a flexible, efficient, and secure platform that organizes and exchanges healthcare data from various sources and formats. Our platform allows our customers to uncover differentiated insights that address their client's needs. In addition, our employees know they play an active role in keeping our customers' data safe and are responsible for ensuring that our comprehensive policies and practices are met.

With our deep expertise in cloud-enabled technologies and knowledge of the healthcare industry, we have built an innovative data integration and management platform that allows healthcare payers access to historically siloed and inaccessible data. Through our platform, these healthcare organizations can ingest and manage all the data they need to transform their business by supporting their analytical, operational, and financial needs.

Since our founding in 2017, Abacus has built a highly successful SaaS business, raising more than $81 Million from leading VC firms with deep expertise in the healthcare and technology industries. We are solving problems of massive scale and complexity in a sector ready for disruption. We're growing quickly and would love for you to be a part of it!

About the Role: 

**This role is based in Pune, India.**Come join our team! Help us tackle the data usability challenge for payers. Your expertise and experience will help drive meaningful performance outcomes. You'll also have the chance to advance your career, acquire new skills, and collaborate with some of the most innovative minds in payer data management. 

We are seeking an experienced Technical Business Analyst with Health Data Interoperability and/or CMS Interoperability subject matter expertise to join our growing team. You will act as a liaison between business stakeholders, data modeling, and technical teams, ensuring compliance with healthcare regulations, seamless data exchange, and efficient data integration between formats and systems. You will contribute expertise and experience in health data interoperability, data mapping and transformation, and technical requirements gathering and analysis to help optimize internal work process coordination and efficiency and help build client-facing data solutions that drive business value for payers in critical program areas like CMS Interoperability, Quality, Risk Adjustment, Provider Data Management, and Value-Based Care. This role will help translate business requirements into actionable, documented technical requirements for hand-off to Implementation and Engineering teams for client onboarding and product development. 

You Will Be Responsible for: 

• Requirements Gathering and Analysis. Define, analyze, and document detailed functional and technical requirements for specific data solutions. Tasks may include collecting requirements from internal SMEs, partnering closely with Client Delivery and/or Customers to gather and refine technical and business requirements, developing and reviewing QA/user acceptance testing criteria, and business systems analysis, including data and gap analyses.
• Stakeholder coordination/collaboration: Be a knowledgeable bridge between clients, product management, data modeling, SMEs, and other team members to define, document and share detailed functional and technical requirements and expected impact using all of the tool in your technical BA toolkit.
• Mock-ups/Prototyping: Create mocks-ups, sample reports, and/or output tables to help visualize and communicate requirements, workflows, and expected results, based on client problems to be solved, business rules, and technical requirements. 
• User Acceptance Testing/QA Process. Collaborate with key stakeholders to define user stories, test cases, QA/User acceptance testing criteria for data solutions.  
• Partnering with Agile Scrum Teams: Participate in relevant agile ceremonies, build user stories according to requirements, and help define test cases and acceptance criteria. 
• Solution Maintenance. Co-own maintenance and create of artifacts that includes but is not limited to document portal/repository, workflows/diagrams, data mapping and technical requirements documents, analytics/business logic, user stories, and UAT scenarios and test cases. 

Must-Have Qualifications: 

• Deep understanding of Health Data Interoperability frameworks and/or CMS Interoperability Rules (e.g., CMS-9115-5, CMS-0057-F, FHIR standards) 
• 5+ years of experience working with US healthcare data (claims, clinical, member, provider, CMS files, etc.) and standards (e.g., HL7, FHIR, EDI, CDA) and integration
• 5+ years of progressive experience in business requirements management (definition, documentation, mock-ups, data analysis
• 3+ years experience participating in UAT process management – test case planning and scenarios, writing UAT acceptance criteria, UAT test case execution, tracking and resolving defects, and UAT closure
• Proficiency in data mapping and data exchange protocols (e.g., API, JSON, XML) related to health information systems.
• Proficiency in SQL, Python, and/or other programming languages for data extraction and transformation.
• Experience with EHRs and/or HIEs and healthcare data workflows. 
• Strong communicator who can share domain expertise effectively across multiple departments from Sales, Client Delivery, Product, Engineering, and Information Security
• "Roll up your sleeves mentality" working side-by-side with your team.
• Self-starter with demonstrated ability to drive workstreams independently and manage risks with strong compass on when to escalate issues.
• Demonstrated ability to thrive in a fast-paced, dynamic startup environment. 

Nice-to-Have Qualifications:

• Working knowledge of US healthcare (one or more) - health insurance markets, government sponsored health plans (Medicare/Medicaid), and/or care delivery and reimbursement models (e.g. VBC, population health, risk adjustment) 
• Familiarity with cloud platforms (e.g., AWS, Azure, Databricks, Snowflake, etc) for hosting healthcare applications and data storage.
• Experience with healthcare analytics and data visualization tools (e.g., Power BI, Tableau)
• Experience with Agile methodologies in healthcare technology projects.
• Interest in Advanced Analytics, Data Science, and/or GenAi 

Equal Opportunity Employer 

As a mission-led technology company that is helping to drive better healthcare outcomes, Abacus Insights believes that the best innovation and value we can bring to our customers comes from diverse ideas, thoughts, experiences, and perspectives. Therefore, we proudly dedicate extensive time and resources to building diverse teams and providing equal employment opportunities to all applicants. Abacus prohibits discrimination and harassment of any type regarding race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.