Lead Business Analyst (Guiding Care)

Job Title: Lead Business Analyst Location: Remote Type: 3-month Contract Compensation: $57/HR Contractor Work Model: 100% Remote ALTA IT Services is seeking a Lead Business Analyst for a high-impact, fast-paced healthcare project with a national health insurance client. This role is responsible for building clinical letters using FICO Blaze within HealthEdge's care coordination platform, GuidingCare. The Lead BA will drive the end-to-end integration of clinical letter development processes, ensuring that all outputs meet strict regulatory and compliance requirements for clinical teams. The ideal candidate is a self-starter, outcomes-driven, and thrives under aggressive timelines. They will collaborate across teams to deliver high-quality, regulation-compliant documentation and systems analysis. Key Responsibilities: • Lead the development and configuration of clinical letters using FICO Blaze, integrated with GuidingCare. • Ensure all letter templates and business rules meet regulatory and clinical team requirements. • Serve as a Subject Matter Expert (SME) on FICO Blaze-GuidingCare integration processes. Business Requirements Management: • Elicit, analyze, document, and validate business and functional requirements for complex healthcare systems and workflows. • Translate business needs into clear technical specifications, business rules, and process flows. • Facilitate and lead requirements gathering and design review sessions with stakeholders. Testing & Quality Assurance: • Own and manage the User Acceptance Testing (UAT) process, including test planning, documentation, and defect resolution. • Identify system gaps, compliance issues, and design deficiencies through root cause analysis and issue resolution planning. Documentation & Communication: • Produce clear, high-quality documentation including business requirements, functional specs, and process diagrams. • Act as a liaison between business users and technical teams to ensure accurate translation of requirements and delivery. Issue Resolution & Support: • Troubleshoot complex problems across systems and processes, collaborating with IT, business, and vendor teams. • Track, prioritize, and manage open issues to resolution in a timely manner. Leadership: • Mentor and guide junior analysts, review deliverables, and assign tasks effectively. • Provide strategic insight into process improvements, requirements development, and regulatory alignment. Required Skills & Experience:Mandatory: • Hands-on experience with FICO Blaze for business rule management and generation of clinical or member communications. • Strong knowledge of GuidingCare, particularly around letter generation and integration workflows. • 5–8+ years of experience as a Business Analyst in the health insurance or healthcare domain. • Proven success in leading complex, high-visibility projects under tight deadlines. • Solid understanding of healthcare compliance, CMS regulations, and payer documentation standards. • Ability to manage multiple priorities in a fast-paced, collaborative environment. Preferred: • Experience with HealthEdge systems or other care management platforms. • Familiarity with clinical workflows, Utilization Management (UM), Care Management (CM), and payer operations. • Experience documenting decision logic or rule-based systems using tools like FICO Blaze or similar. System One, and its subsidiaries including Joulé, ALTA IT Services, and Mountain Ltd., are leaders in delivering outsourced services and workforce solutions across North America. We help clients get work done more efficiently and economically, without compromising quality. System One not only serves as a valued partner for our clients, but we offer eligible employees health and welfare benefits coverage options including medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as participation in a 401(k) plan. System One is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, age, national origin, disability, family care or medical leave status, genetic information, veteran status, marital status, or any other characteristic protected by applicable federal, state, or local law. #M2 #DI-AJ1 Ref: #850-Rockville (ALTA IT)