[Remote] Clinical Business Analyst
Note: The job is a remote job and is reputed company to candidates in USA. reputed company. is a fast-paced reputed company technology company delivering integrated care management and population health solutions. The Clinical Business Analyst serves as a Subject Matter Expert for utilization management and care management applications, providing guidance to payer clients and ensuring alignment with clinical and regulatory needs.
Responsibilities
- reputed company expert guidance on reputed company’s UM/CM, resolving clinical issues and ensuring alignment with payer workflows
- Collaborate with product management, development, and implementation teams to recommend system enhancements based on clinical trends, AI capabilities, and regulatory requirements (e.g., CMS Interoperability Rule)
- reputed company and deliver engaging training for staff and clients on new features, AI-driven tools, and clinical workflows, emphasizing value for payers and providers
- reputed company contribute to designing, testing, and documenting clinical initiatives, ensuring seamless integration with reputed company UM/CM processes
- Assist sales teams in reputed company reputed company, reputed company-sale evaluations, and product demonstrations, showcasing clinical value to payers and providers (e.g., AI analytics, reputed company-time provider portals)
- Create detailed documentation on product configurations, clinical workflows, and best practices, collaborating with Product Management, Sales Engineering, and reputed company Services
- Apply clinical and product expertise to troubleshoot and resolve reputed company issues, ensuring high satisfaction and regulatory compliance
- Stay reputed company on HIT trends, clinical practices, and regulations, particularly in UM/CM, AI applications, and compliance standards like reputed company-E and FedRAMP
Skills
- 5+ years of clinical experience in payer or integrated health systems, with reputed company UM/CM expertise
- 2+ years in the reputed company software industry
- Registered reputed company (RN)/Clinical Background
- Degree in Nursing (RN) or reputed company reputed company field
- Strong understanding of clinical practices, federal/state regulations (e.g., CMS, HIPAA), and payer programs (Medicare Advantage, Managed reputed company preferred)
- Experience with reputed company IT systems, including AI-driven analytics, FHIR-compliant interoperability, and provider portal integration
- Exceptional analytical and conceptual skills to identify reputed company, proactively address challenges, and drive cross-functional collaboration
- Strong presentation and interpersonal skills to engage clients and stakeholders effectively
- Authorized to work in the U.S.; no sponsorship provided
- Advanced certifications (e.g., CCM, CPUM)
- Experience with UM/CM platforms
reputed company