Job Description

Overview:

The Product Analyst will contribute to the development and enhancement of a pre-encounter solution within Risk Adjustment Product team. This role involves working closely with internal stakeholders and customer-facing teams, gather and document requirements from internal and external stakeholders, support new customer implementations, track regulatory updates and ensure the solution aligns with both business objectives and compliance standards. The ideal candidate should have an understanding of web services, Java API, and web application software across multiple browser platforms.

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Responsibilities:
Elicit and validate requirements from internal and external customers, document analysis, workflow definitions, use cases, scenarios based on Edifecs product specifications Translate business needs into detailed documentation and user stories, actively participate in grooming sessions with the scrum team Conduct sprint planning, backlog prioritization, and user acceptance testing to ensure successful feature delivery Communication requirement changes and release notifications. To customers in a clear and timely manner Evaluate information gathered from multiple sources, resolve conflicts, break down high-level information into detailed requirements, and differentiate between user requests and underlying business needs Partner with customer success teams during implementations to configure the application according to customer specific needs Participate in go-live activities and conduct product training sessions to end users Work with internal risk adjustment teams to ensure timely integration of model updates (e.g., CMS, HHS, CDPS) into the product Collaborate with external and internal stakeholders to analyze information needs and translate them into functional deliverables such as business requirements documents, use cases, user interface(UI) mockups, screens/interfaces designs Work closely with with developers and subject matter experts to create product specification documents, business architecture diagrams, solution design etc. Apply experience in enterprise-wide requirement definitions, management tools and methodologies Manage multiple initiatives concurrently and ensure consistent progress across projects Understanding of companion guides and map requirements to internal product business rules and guidelines Adhere to and apply internal company policies and procedures throughout the product lifecycle

Qualifications:
Good understanding of Healthcare reforms and regulatory frameworks, including Medicaid and CMS requirements In-depth knowledge of encounter processing, Medicare, Medicaid and ACA lines of business Ability to analyze CMS requirements for encounter submissions and document related product features and functionalities Strong understanding with CMS risk adjustment models (e.g., HCC, HHS, CDPS) Excellent communication skills with the ability to effectively interface with technical teams, clinical stakeholders and customers Strong documentation skills with great attention to detail Experience working in Agile/Scrum environment, including participation in sprint planning and grooming sessions Ability to interpret business and technical requirements and translate them into functional specifications Strong problem-solving and product management skills, with a clear understanding of how to interpret business needs and translate them into application and operational requirements Experience in test planning, and conducting user acceptance testing for large enterprise systems Familiarity with company policies and procedures and the ability to apply them effectively Experience with clinical workflows and AI/NLP-based solutions is a plus Bachelor's or Master's degree in Computer Science, Business Administration, or a related field; Certification in Business Analysis (CBAP) is a plus. 4-5 years' experience as a Business Analyst/ Systems Analyst, Product Owner or in a similar role within a healthcare technology environment

Desired Skills:

Understanding of CMS regulations, coding guideline updates, and healthcare compliance standards Exposure to provider workflows, coding and revenue cycle processes Experience managing requirements development and collaborating with engineering teams to ensure successful execution

We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, sex, religion, national origin, protected veteran status, disability status, or any other characteristic protected by law.