Business Systems Analyst - Health Insurance Experience Required

Company:  Aureon Consulting
Location: Des Moines
Closing Date: 26/10/2024
Hours: Full Time
Type: Permanent
Job Requirements / Description

DIRECT APPLICANTS ONLY - NO 3RD PARTY INQUIRIES PLEASE

Aureon Consulting has an immediate need for an experienced Business Systems Analyst (BSA) to join a consulting effort that will involve enhancing healthcare interoperability through the implementation of FHIR and HL7 standards and will be instrumental in ensuring compliance with the CMS-0057 rule. The BSA will collaborate with cross-functional teams to design, develop, and optimize system integrations that facilitate efficient and secure data exchange across healthcare platforms.

** Resumes submitted MUST reflect a strong project history with FHIR and HL7 specific efforts and a solid track record of success. **

Key Responsibilities:

  • Experience eliciting high-level and detailed functional and non-functional business requirements by using a variety of elicitation techniques in multiple project contexts.
  • Previous involvement with enterprise wide, cross functional, and complex projects that involve multiple business areas.
  • Experience with different phases of testing (such as end-to-end, system integration, user acceptance, functional and non-functional, etc.).
  • Knowledge of software development processes and understanding of technology, systems environments, and enterprise architecture.
  • Lead the analysis and design of interoperability solutions using FHIR and HL7 standards.
  • Ensure seamless integration and data exchange between disparate healthcare systems.
  • Collaborate with stakeholders to gather requirements and define system specifications.
  • Develop and document workflows, data flows, and system interactions for interoperability projects.
  • Serve as the subject matter expert for FHIR and HL7 standards within the organization.
  • Design and implement FHIR-based APIs and services for data exchange.
  • Manage and troubleshoot HL7 message integrations, including ADT, ORM, and ORU messages.
  • Develop and maintain documentation for FHIR resources and HL7 message mappings.
  • Lead efforts to ensure compliance with the CMS-0057 rule (Advancing Interoperability and Improving Prior Authorization Processes Proposed Rule).
  • Analyze regulatory requirements and translate them into actionable system requirements and workflows.
  • Collaborate with compliance and legal teams to stay updated on regulatory changes and impacts.
  • Implement and monitor processes to ensure ongoing compliance with CMS-0057 and other relevant regulations.
  • Stay current with advancements in interoperability technologies and standards.
  • Identify opportunities for process improvement and enhanced system performance.
  • Contribute to the development and adoption of best practices for system integration and data management.

Qualifications:

  • Educational Background:

Bachelor's degree in Computer Science, Information Systems, Health Informatics, or a related field. Advanced degree or relevant certifications (e.g., HL7 Certification, FHIR Proficiency) preferred.

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