Trinetix

Business Analyst

Trinetix

full-time

Posted on:

Origin:  • 🇺🇸 United States • Tennessee

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Job Level

Mid-LevelSenior

Tech Stack

AWSAzureCloudGoogle Cloud PlatformSQLTableau

About the role

  • Trinetix is seeking an experienced Business Analyst / Data Analyst with strong expertise in US healthcare data, claims processing, and Accountable Care Organizations (ACO)
  • Role will contribute to product development and client implementations, ensuring data-driven insights and solutions
  • Collaborate with product managers, engineering teams, and clients to define business requirements and translate them into functional specifications
  • Perform data analysis on US healthcare claims data (professional, institutional, and pharmacy claims) and CCLF data sets to support product features and client needs
  • Support design and validation of ACO-related reporting, quality metrics, and performance monitoring dashboards
  • Serve as subject matter expert (SME) on healthcare claims data, ACO models, and CMS programs in client discussions
  • Conduct gap analysis, data mapping, and requirements gathering for product features and client onboarding
  • Develop data validation, testing, and reconciliation strategies to ensure data quality and compliance
  • Create functional and technical documentation including BRDs, FRDs, user stories, acceptance criteria, and data dictionaries
  • Partner with implementation teams to ensure successful product deployment, integration, and client adoption
  • Stay updated on CMS regulations, ACO program changes, and healthcare interoperability standards

Requirements

  • 5–7 years of experience as a Business Analyst / Data Analyst in the US healthcare domain
  • Strong understanding of US healthcare claims data (institutional, professional, pharmacy claims, eligibility, provider)
  • Hands-on experience with CCLF (Claim and Claim Line Feed) data – data structures, use cases, validation, and reporting
  • Working knowledge of ACO programs (MSSP, ACO REACH, Shared Savings Programs) including attribution models, quality measures, and performance metrics
  • Familiarity with CMS interoperability standards – FHIR, HL7, USCDI
  • Understanding of risk adjustment models (HCC coding, RAF scores)
  • Exposure to Medicare/Medicaid datasets beyond CCLF (MAO-004, MMR, PDE, etc.)
  • Experience in requirement gathering, gap analysis, data mapping, BRD/FRD documentation, and writing user stories
  • Proven track record in product development lifecycles and client implementation projects
  • Excellent communication skills with ability to interact with product teams, engineers, and client stakeholders
  • Nice-to-have: Experience with BI & analytics tools (Tableau, Power BI, Qlik); experience working in healthcare payer/provider settings; strong SQL and data analysis skills; experience with cloud platforms (AWS, Azure, GCP); knowledge of healthcare regulatory updates (CMS rule changes, MACRA, MIPS, QPP); prior experience in a SaaS product company or healthcare data platform implementation; hands-on with Agile methodology / Jira / Confluence; Bachelor’s degree in Healthcare Informatics, Business, Data Science, or a related field