Abacus Insights is a mission-driven, growth-stage technology company focused on transforming the healthcare industry, ultimately creating a more personalized patient experience, improving health outcomes, and lowering the overall cost of healthcare. Abacus Insights provides a flexible, efficient, and secure platform that organizes and exchanges healthcare data from various sources and formats. Our platform allows our customers to uncover differentiated insights that address their client's needs. In addition, our employees know they play an active role in keeping our customers' data safe and are responsible for ensuring that our comprehensive policies and practices are met.
With our deep expertise in cloud-enabled technologies and knowledge of the healthcare industry, we have built an innovative data integration and management platform that allows healthcare payers access to historically siloed and inaccessible data. Through our platform, these healthcare organizations can ingest and manage all the data they need to transform their business by supporting their analytical, operational, and financial needs.
Since our founding in 2017, Abacus has built a highly successful SaaS business, raising more than $81 Million from leading VC firms with deep expertise in the healthcare and technology industries. We are solving problems of massive scale and complexity in a sector ready for disruption. We're growing quickly and would love for you to be a part of it!
About the Role:
**This role is based in Pune, India.**Come join our team! Help us tackle the data usability challenge for payers. Your expertise and experience will help drive meaningful performance outcomes. You'll also have the chance to advance your career, acquire new skills, and collaborate with some of the most innovative minds in payer data management.
Come join our team! Help us tackle the data usability challenge for payers. Your expertise and experience will help drive meaningful performance outcomes. You'll also have the chance to advance your career, acquire new skills, and collaborate with some of the most innovative minds in payer data management.
We are seeking an experienced Business Analyst with payer-focused healthcare data management subject matter expertise to join our growing team. You will act as a liaison between business stakeholders, the data modeling team, and technical teams, ensuring client needs and business requirements are translated into actionable technical specifications resulting in seamless data exchange and efficient data integration between formats and systems. You will contribute expertise and experience working with payer data - claims, eligibility, clinical, enrollment, provider and member data to support analytic and operational program needs in areas such as Quality, Total Cost of Care Management, Value-based care, Risk Adjustment, Provider Performance, etc. Additionally, your demonstrated expertise in business requirements gathering, data analysis, and source to target data mapping will help optimize client implementation and solve for some of payers’ most pressing business challenges.
You Will Be Responsible for:
- Requirements Gathering and Analysis. Define, analyze, and document detailed functional and technical requirements for specific data solutions. Tasks may include collecting requirements from internal SMEs, partnering closely with Client Delivery and/or Customers to gather and refine technical and business requirements, developing and reviewing QA/user acceptance testing criteria, and business systems analysis, including data and gap analyses.
- Stakeholder coordination/collaboration: Be a knowledgeable bridge between clients, product management, data modeling, SMEs, and other team members to define, document and share detailed functional and technical requirements and expected impact using all of the tool in your technical BA toolkit.
- Mock-ups/Prototyping: Create mocks-ups, sample reports, and/or output tables to help visualize and communicate requirements, workflows, and expected results, based on client problems to be solved, business rules, and technical requirements.
- User Acceptance Testing/QA Process. Collaborate with key stakeholders to define user stories, test cases, QA/User acceptance testing criteria for data solutions.
- Partnering with Agile Scrum Teams: Participate in relevant agile ceremonies, build user stories according to requirements, and help define test cases and acceptance criteria.
- Solution Maintenance. Co-own maintenance and create of artifacts that includes but is not limited to document portal/repository, workflows/diagrams, data mapping and technical requirements documents, analytics/business logic, user stories, and UAT scenarios and test cases.
- Continual Learning. Keep up to date on latest industry trends in how payers are using data to drive improvement in outcomes. Leverage this expertise to continue to refine how solutions are developed and refined to maximize value for clients.
Must-Have Qualifications:
- 5+ years experience in the US healthcare payer market and key program areas including quality management (HEDIS, Star Ratings), risk adjustment (CMS, HHS, State-based), population health, value-based care, total cost of care management, etc.
- 5+ years of hands on experience working with payer data types - claims, eligibility, clinical, enrollment, provider and member data
- 5+ years of progressive experience gathering and documenting requirements including, eliciting business requirements, creating user stories, conducting data/gap analysis, and writing data validation checks as part of requirements gathering
- 3+ years experience participating in UAT process management – test case planning and scenarios, writing UAT acceptance criteria, UAT test case execution, tracking and resolving defects, and UAT closure
- Proficiency with coding standards including ICD-10, CPT, HCPCS, SNOMED, LOINC, NDC, and RxNorm
- Proficiency in source to target data mapping using interoperable standards, and data exchange protocols (e.g., API, JSON, XML) related to health information systems
- Proficiency with data analysis, data visualization, and project management tools such as Excel, SQL, PowerBI, Tableau, JIRA, Confluence, etc.
- Strong cross-functional communicator
- Excellent organizational skills with the ability to manage multiple projects and timelines
- Strong attention to detail and commitment to data integrity and compliance
- "Roll up your sleeves mentality" working side-by-side with your team
- Self-starter with demonstrated ability to drive workstreams independently and manage risks with strong compass on when to escalate issues
Nice-to-Have Qualifications:
- Experience with EHRs and/or HIEs and healthcare data workflows.
- Familiarity with cloud platforms (e.g., AWS, Azure, Databricks, Snowflake, etc.) for hosting healthcare applications and data storage.
- Experience with Agile methodologies in healthcare technology projects
- Proficiency with programming languages (e.g. Python)
- Interest in Advanced Analytics, Data Science, and/or GenAi
Equal Opportunity Employer
As a mission-led technology company that is helping to drive better healthcare outcomes, Abacus Insights believes that the best innovation and value we can bring to our customers comes from diverse ideas, thoughts, experiences, and perspectives. Therefore, we proudly dedicate extensive time and resources to building diverse teams and providing equal employment opportunities to all applicants. Abacus prohibits discrimination and harassment of any type regarding race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.