vTek Systems Inc is seeking a Lead Clinical Business Analyst to support the CMS-0057-F interoperability mandate focused on improving electronic data exchange and prior authorization workflows. The role involves gathering and documenting requirements for API-driven projects and collaborating closely with business and technical teams to ensure compliance with relevant mandates.

Responsibilities:

Gather & document requirements for API-driven projects (UM, Patient & Provider Access)
Work closely with business & technical teams to drive delivery
Manage user stories and ensure compliance with CMS & BCBSA mandates

Requirements:

10+ years as Business Analyst
Experience with CMS-0057-F mandate (must have)
Strong experience in API requirements gathering & documentation
Experience working with healthcare platforms like GuidingCare, Medecision, Jiva, MCG, or InterQual
GuidingCare or MCG experience

Clinical Business Analyst

Key skills

About this role

Responsibilities:

Requirements: