Must have US Healthcare Interoperability experience
Knowledge of health data exchanges standards (such as HL7, FHIR, CDA, API, EDI, etc.), clinical data terminologies (such as SNOMED, CPT, LOINC, etc.)
Knowledge of healthcare Payer domain and workflows, compliance, and regulatory requirements (Prior Authorizations, Claims, Clinical Data exchange, etc..)
Either EPIC Payor or Provider knowledge is Must.
Good to have knowledge of FHIR, HL& transactions.
US Healthcare domain knowledge is must.
Provider workflow knowledge is must – must be aware of Provider credentialing, contracting, onboarding, network management.
PDM (provider data management) knowledge is added advantage.
Responsibilities:
Works within identified scope of project, gathers business requirements by working with business stakeholders, Business Architecture, IT and Vendors (or cross-functional technical teams).
Works within identified scope of project, gathers business requirements by working with business stakeholders, Business Architecture, IT and Vendors (or cross-functional technical teams).
Must have worked on creating BRD, FRDs, UML and flow diagram.
Ability to facilitate business requirement, elicitation sessions with multiple stakeholders
Ability to perform UAT on Business requirements & Reports validation.
Capture and write document business requirements including system application flows and impacts.
Development of new process flows and functionality integration and adding any needed clarity to requirements as well as documenting progress.
Identifies potential issues and risks after conducting a gap analysis.