Clinical Business Analyst

InfoMC, Inc. is a fast-paced healthcare technology company delivering integrated care management and population health solutions. The Clinical Business Analyst serves as a Subject Matter Expert for utilization management and care management applications, providing guidance to payer clients and ensuring alignment with clinical and regulatory needs.

Responsibilities:

• Provide expert guidance on InfoMC’s UM/CM, resolving clinical issues and ensuring alignment with payer workflows
• Collaborate with product management, development, and implementation teams to recommend system enhancements based on clinical trends, AI capabilities, and regulatory requirements (e.g., CMS Interoperability Rule)
• Develop and deliver engaging training for staff and clients on new features, AI-driven tools, and clinical workflows, emphasizing value for payers and providers
• Actively contribute to designing, testing, and documenting clinical initiatives, ensuring seamless integration with client UM/CM processes
• Assist sales teams in lead generation, pre-sale evaluations, and product demonstrations, showcasing clinical value to payers and providers (e.g., AI analytics, real-time provider portals)
• Create detailed documentation on product configurations, clinical workflows, and best practices, collaborating with Product Management, Sales Engineering, and Client Services
• Apply clinical and product expertise to troubleshoot and resolve client issues, ensuring high satisfaction and regulatory compliance
• Stay current on HIT trends, clinical practices, and regulations, particularly in UM/CM, AI applications, and compliance standards like MARS-E and FedRAMP

Requirements:

• 5+ years of clinical experience in payer or integrated health systems, with direct UM/CM expertise
• 2+ years in the healthcare software industry
• Registered Nurse (RN)/Clinical Background
• Degree in Nursing (RN) or related healthcare field
• Strong understanding of clinical practices, federal/state regulations (e.g., CMS, HIPAA), and payer programs (Medicare Advantage, Managed Medicaid preferred)
• Experience with healthcare IT systems, including AI-driven analytics, FHIR-compliant interoperability, and provider portal integration
• Exceptional analytical and conceptual skills to identify innovative solutions, proactively address challenges, and drive cross-functional collaboration
• Strong presentation and interpersonal skills to engage clients and stakeholders effectively
• Authorized to work in the U.S.; no sponsorship provided
• Advanced certifications (e.g., CCM, CPUM)
• Experience with UM/CM platforms