Healthcare Business Analyst with HL7 &FHIR

Healthcare Business Analyst with HL7 & FHIR

Philadelphia, PA (Hybrid, 3 days onsite)

Tentative Duration - 6 months +

This role is for a business analysis to support data-exchange initiatives in Data Integration Department within Enterprise Data office with a strong focus on HL7 standards (FHIR, CCD, ADT, SIU) to ensure regulatory compliance (CMS, ONC) and data integrity. The position requires deep healthcare data expertise and the ability to independently drive requirements, translate business needs into technical specifications, partner closely with IT teams, and mentor junior Business Analysts.

Job Functions:

Conduct end-to-end requirements gathering, independently managing discovery, analysis, and solution definition with business and IT stakeholders.

Serve as a subject-matter expert on CMS Interoperability and HL7 exchange protocols, including FHIR, CCDs, ADTs, etc.

Perform hands-on data analysis using SQL, Databricks, and related tools to validate data, troubleshoot issues, and support design decisions.

Document business and technical requirements, source-to-target mappings, data specifications, business rules, and process flows.

Support validation and QA by reviewing data outputs, test cases, and results to ensure accuracy and compliance.

Collaborate with internal teams and external partners with minimal supervision to gather requirements, drive key decisions, and support successful implementations.

Communicate business and process solutions, recommendations, and issues to ACFC management on a regular basis.

Document all business process flows related to interoperability initiatives.

Apply working knowledge of ACFC Managed Care functions (HealthCare Services, Claims, Enrollment, Quality/HEDIS, Risk Adjustment, Care Management, Utilization Management) to support problem-solving and solution design.

Provide strong communication and status updates to business and IT stakeholders and management.

Build consensus among users, IT, and senior leadership on business problems and solution approaches.

Address most inquiries independently, escalating only when appropriate.

Distinguish between routine and sensitive matters and promptly apprise management when needed.

Ensure requests are addressed promptly, professionally, and with persistence in gathering required information.

Meet with external vendors to evaluate products and ensure ACFC requirements are met.

Communicate effectively with senior and mid-level management.

Understand chain of command, decision-making roles, and communicate accordingly.

Demonstrate strong analytical and problem-solving skills, including evaluating alternatives, recommending solutions, and articulating impacts.

Produce clear, well-structured written and verbal communications.

Brief management appropriately when issues require senior-level attention.

Qualifications:

8 10 years of experience in healthcare IT, data integration, or business analysis.

Experience with FHIR, HL7 clinical data-exchange standards (CCD/ADT/SIU) and healthcare terminology (LOINC, ICD-10, CPT, etc.).

Ability to interpret large datasets and deliver evidence-based recommendations.

Strong organizational, analytical, and interpersonal skills.