Business Analyst – EPA (Electronic Prior Authorization)

Role Summary We are seeking an experienced Business Analyst (BA) to lead and support business analysis for Electronic Prior Authorization (ePA) initiatives aligned with CMS 0057 requirements. This role will focus on enabling streamlined prior authorization workflows, interoperability, and collaboration between business, clinical, and technical teams. Key Responsibilities: • Gather, analyze, and document business and functional requirements for ePA workflows • Translate requirements into user stories, acceptance criteria, and process flows • Facilitate Sprint Planning and Backlog Refinement sessions • Coordinate with stakeholders and vendors to ensure timely delivery • Identify risks and recommend corrective actions • Support quality assurance, process improvements, and operational alignment Role Summary We are seeking an experienced Business Analyst (BA) to lead and support business analysis for Electronic Prior Authorization (ePA) initiatives aligned with CMS 0057 requirements. This role will focus on enabling streamlined prior authorization workflows, interoperability, and collaboration between business, clinical, and technical teams. Key Responsibilities • Gather, analyze, and document business and functional requirements for ePA workflows • Translate requirements into user stories, acceptance criteria, and process flows • Facilitate Sprint Planning and Backlog Refinement sessions • Coordinate with stakeholders and vendors to ensure timely delivery • Identify risks and recommend corrective actions • Support quality assurance, process improvements, and operational alignment Required Skills • Strong experience in Business Analysis within regulated healthcare or payer environments • Hands-on experience with Electronic Prior Authorization (ePA) and interoperability initiatives • Solid understanding of Agile / Scrum methodologies • Experience with tools such as Jira or Azure DevOps (ADO) • Ability to create clear documentation, workflows, and process diagrams Preferred / Nice to Have • Experience with FHIR-based APIs • Knowledge of CMS 0057 regulations • Basic experience with SQL and/or Python • Strong analytical and communication skills • Strong experience in Business Analysis within regulated healthcare or payer environments • Hands-on experience with Electronic Prior Authorization (ePA) and interoperability initiatives • Solid understanding of Agile / Scrum methodologies • Experience with tools such as Jira or Azure DevOps (ADO) • Ability to create clear documentation, workflows, and process diagrams Preferred / Nice to Have • Experience with FHIR-based APIs • Knowledge of CMS 0057 regulations • Basic experience with SQL and/or Python • Strong analytical and communication skills