Description

• We are seeking a Senior Healthcare Business Analyst to join our Digital Technology division, driving key data exchange initiatives for Health100—our AI-native healthcare engagement platform and ecosystem.
• In this role, you will bridge the gap between clinical/operational needs and technical implementation for Health100.You will lead the analysis, mapping, and implementation of healthcare data exchange protocols, ensuring seamless interoperability across systems using FHIR, HL7 v2/v3, and C-CDA to FHIR transformations. Your technical depth in healthcare standards combined with strong analytical capabilities will drive the design of
• scalable data workflows for AI-driven healthcare solutions.

Key Responsibilities:

Healthcare Data Exchange & Interoperability:

• Lead data mapping initiatives, specifically defining transformational rules for CCDA to FHIR, HL7 v2/v3 to FHIR, and proprietary clinical formats.
• Ensure strict adherence to HL7 FHIR R4 / SMART on FHIR standards for real-time patient data ingestion, cost transparency tools, and pharmacy engagement
• workflows.
• Oversee data governance, privacy compliance (CARIN Code of Conduct for Consumer-Facing Applications, HIPAA), and secure consent management frameworks across consumer data-sharing platforms.

Requirements Analysis:

• Gather, document, and refine business and functional requirements for integration into the CVS Health100™ platform.
• Conduct gap analysis between legacy core systems (EHRs, pharmacy operating systems, claims processing platforms) and modern FHIR-based APIs.

Cross-Functional Collaboration & Execution:

• Collaborate with third-party digital health partners, health plans, and provider organizations integrating into the Health100™ open ecosystem.
• Partner closely with data engineering, cloud software architects, and AI developers working with Google Cloud technologies (BigQuery, Cloud Healthcare API, Gemini models) to build real-time clinical workflows.
• Design and execute end-to-end User Acceptance Testing (UAT), including sample payload generation (JSON/XML) and validating output data integrity.

Required Qualifications:

• Experience: 5+ years of Business Analyst experience in the healthcare, health insurance (payer), or health-tech domains.
• Interoperability Standards Expertise: Strong hands-on understanding of key standards:
• FHIR: FHIR R4 resources (Patient, Encounters, Diagnostic Report,MedicationRequest, Observation, Service Requests etc), SMART on FHIR, and profile extensions.
• HL7: HL7 v2/v3 messaging structures (ADT, ORU, VXU).
• C-CDA: Clinical Document Architecture parsing, data mapping techniques, and CCDA FHIR conversion workflows.
• Regulatory Knowledge: Deep understanding of the CMS/ONC Interoperability and Patient Access Final Rules, TEFCA, and CARIN Alliance consumer access guidelines.
• Technical Skills: Experience with API testing tools (Postman, Insomnia), payload formats (JSON, XML), and SQL querying capabilities for data validation.
• Agile Delivery: Proven experience in Agile/Scrum environments using tools like Jira and Confluence

Key Skills

Education

Bachelor's degree