Lead Business Analyst

At ValueMomentum's Technology Center, we are a team of passionate engineers who thrive on tackling complex business challenges with innovative solutions while transforming the P&C insurance value chain. We achieve this through strong engineering foundation and continuously refining our processes, methodologies, tools, agile delivery teams, and core engineering archetypes. Our core expertise lies in six key areas: Cloud Engineering, Application Engineering, Data Engineering, Core Engineering, Quality Engineering, and Domain expertise Role – Lead Business Analyst Location – New Jersey Primary Responsibilities Requirements Leadership • Own end-to-end business and functional requirements for ePA, CRD, DTR, and PAS. • Facilitate requirement sessions across business, operations, and technology teams. • Translate regulatory requirements into business and technical requirements. • Maintain requirements traceability from CMS regulations through implementation and testing. Vendor Management • Act as primary day-to-day requirements lead with Vendor Management. • Review vendor assumptions, solution designs, workflows, and implementation approaches. • Track gaps, risks, dependencies, and open decisions. FHIR & Interoperability Analysis • Understand CRD, DTR, PAS, Patient Access, Provider Access, and Payer-to-Payer workflows. • Analyze FHIR resource requirements and data mapping needs. • Partner with API teams on business workflow impacts. Cross-Team Coordination Testing & Readiness • Define business test scenarios. • Coordinate end-to-end testing. • Validate provider workflows. Required Experience • 8+ years as BSA/Product Owner/Product Manager • Healthcare payer experience • Prior Authorization experience • Vendor management experience • API integration experience • Strong facilitation and stakeholder management skills Highly Preferred • FHIR • CMS-0057-F • CRD/DTR/PAS • HL7 • Interoperability programs • Utilization Management workflows • Medical Policy systems.