Lead Business Analyst
Sprinklr
Job Level
Mid-LevelSenior
Tech Stack
SQLTableau
About the role
- Collaborate with stakeholders (clinical, operational, technical) to gather, document, and validate business and functional requirements
- Facilitate workshops, interviews, and focus groups across departments such as Utilization Management, Risk Adjustment, Quality, and Member Services
- Analyze claims, clinical, eligibility, provider, and quality data to uncover trends, anomalies, and opportunities
- Build dashboards and reports using SQL, Tableau, Power BI, or Excel
- Translate business requirements into technical specifications for development teams
- Participate in solution design, user acceptance testing (UAT), and validation of healthcare systems (EHR, claims systems, portals, etc.)
- Support CMS, HEDIS, NCQA, and other regulatory or audit initiatives through documentation, gap analysis, and impact assessments
- Track changes to healthcare regulations and ensure systems/processes remain compliant
- Identify inefficiencies in workflows, lead process mapping exercises, and recommend optimizations
- Work closely with IT, data science, product management, and clinical operations teams as a liaison between technical and non-technical teams
Requirements
- Bachelor's degree in Healthcare Administration, Public Health, Information Systems, Business, or related field
- Master’s degree is a plus
- 3–7 years of experience in a healthcare-focused BA role (payer, provider, or health tech environment)
- Experience with healthcare data sources such as claims (837/835), enrollment (834), HL7, FHIR, or EMRs
- Proficiency in SQL
- Experience with data visualization tools (Power BI, Tableau, Excel)
- Familiarity with JIRA, Confluence, or other agile project management tools
- Understanding of healthcare regulations (CMS, HIPAA), payer operations, and/or clinical workflows
- Exposure to risk adjustment, quality measurement (HEDIS, STAR), or care management processes preferred
- Excellent analytical, problem-solving, and communication skills
- Ability to work independently in a fast-paced, evolving environment
- Preferred certifications: Certified Business Analysis Professional (CBAP), Six Sigma or Lean, AHIP, CPC
