Business Analyst - ( 5 Months Contract )

• Lead and support business analysis for electronic prior authorization (ePA) delivery to meet CMS 0057 requirements for streamlined PA workflows and interoperability.
• Translate regulatory and business needs into clear requirements, user stories, and actionable plans.
• Facilitate collaboration and communication between U.S. stakeholders, clinical/UM teams, and distributed development teams. Key Responsibilities:
• Gather, analyze, and document business and functional requirements for ePA workflows and FHIR based API obligations.
• Translate requirements into user stories, acceptance criteria, and process flows.
• Facilitate sprint planning, backlog refinement, and stakeholder communication.
• Track delivery progress, identify risks (including UM vendor coordination), and recommend corrective actions
• Support quality, process improvements, and operational alignment.

Technical Skills & Tools

• Business analysis in regulated software delivery focused on ePA and interoperability.
• Strong understanding of Agile methodologies.
• Experience with requirement and project tracking tools (e.g., Jira, ADo).
• Ability to create clear documentation and workflow diagrams. SQL, Python

Desired Attributes:

• Strong analytical and problem-solving skills
• Clear communication with technical and business teams
• High attention to detail and organization
• Collaborative and proactive mindset

Key Activities:

Requirements Definition : Define and translate CMS-0057 ePA requirements such as FHIR-based Prior Authorization API elements, mandated response timelines ( 72 hrs expedited; 7 days standard), and structured denial reasons for payer systems

PA Workflow & UM Integration Analyze current PA processes with Utilization Management teams and UM vendors, map gaps, and document requirements for automated ePA submission, status updates, and decision workflows.

ePA Solution Translation & Planning : Convert regulatory and operational needs into user stories, acceptance criteria, and workflow diagrams that guide development of payer ePA APIs, internal systems, and provider interfaces.

Delivery & Implementation : Collaborate with cross-functional teams to monitor ePA development, manage UM vendor/API dependencies, validate deliverables against CMS timelines and support payer compliance reporting.