Healthcare Business Analyst

Position Overview

We are seeking an experienced Business Analyst with a strong background in healthcare or medical center environments. The ideal candidate will have hands-on experience supporting eClinicalWorks (or similar EHR systems), EDI transactions, and value-based care initiatives. This role will partner with clinical, operational, revenue cycle, and IT teams to drive process improvements, system enhancements, and data-driven decision-making.

Key Responsibilities

Business Analysis & Requirements Gathering

• Collaborate with clinical, operational, billing, and executive stakeholders to gather and document business and system requirements.
• Translate healthcare workflows into detailed BRDs, FRDs, user stories, process maps, and functional specifications.
• Analyze current-state processes and recommend improvements aligned with organizational goals.

EHR / eClinical Support

• Support configuration, optimization, and enhancement of eClinicalWorks (or similar EHR systems).
• Work closely with clinical teams to improve documentation workflows, templates, order sets, and reporting.
• Assist with system upgrades, integrations, testing, and user training.

EDI & Revenue Cycle

• Support EDI transactions including 837 (claims), 835 (remittance), 270/271 (eligibility), and 277CA (claim status).
• Partner with billing and clearinghouse vendors to troubleshoot claim rejections, denials, and interface issues.
• Analyze revenue cycle KPIs and recommend process improvements to increase reimbursement accuracy and speed.

Value-Based Care & Reporting

• Support value-based care initiatives including HEDIS, quality metrics, risk adjustment (RAF), and population health reporting.
• Develop dashboards and reports to monitor provider performance, quality measures, and cost outcomes.
• Partner with care management and clinical leadership to ensure accurate data capture for incentive programs.

Testing & Implementation

• Lead or support UAT planning, test case creation, execution, and defect tracking.
• Coordinate cross-functional teams during system implementations and enhancements.
• Ensure compliance with HIPAA and healthcare regulatory standards.

Qualifications

• Bachelor’s degree: in Healthcare Administration, Information Systems, Business, or related field.
• Experience: 3–7+ years of Business Analyst experience within a healthcare or medical center setting.
• Hands-on experience: with eClinicalWorks (strongly preferred) or other EHR/EMR systems.
• Experience: with healthcare EDI transactions and revenue cycle processes.
• Knowledge: of value-based care models, HEDIS, quality reporting, and risk adjustment.
• Strong understanding: of healthcare operations, clinical workflows, and payer-provider interactions.
• Experience: creating BRDs, user stories, process maps, and conducting UAT.
• Proficiency: in Excel (advanced), and experience with reporting tools (Power BI, Tableau, or similar).

Preferred Skills

• Experience working with managed care organizations or MSOs.
• Familiarity with population health platforms.
• SQL or data analysis experience.
• Bilingual (English/Spanish) a plus.

Key Competencies

• Strong analytical and problem-solving skills.
• Excellent communication and stakeholder management abilities.
• Detail-oriented with strong documentation skills.
• Ability to work in fast-paced healthcare environments.

Must be local to Miami, FL.

This role is ideal for a Business Analyst who understands both the clinical and operational sides of healthcare and can drive improvements across EHR systems, revenue cycle operations, and value-based care programs.