[Remote] Business Analyst

Note: The job is a remote job and is open to candidates in USA. Fractal is a strategic AI partner to Fortune 500 companies, aiming to enhance human decision-making in enterprises. The Business Analyst will work with various teams to analyze business processes and define requirements to improve clinical outcomes and operational efficiency.ResponsibilitiesProvider Network AnalysisAnalyze provider network operations including contracting, credentialing, directory management, network adequacy, and access standardsSupport initiatives related to network optimization, provider performance, and value‑based care arrangementsGather and document requirements for provider data management, directory accuracy, and compliance reportingAct as a liaison between business users and technical teams for provider network systemsAnalyze Care Management workflows, including utilization management, case management, disease management, and population health programsSupport process improvements around prior authorization, referrals, transitions of care, and closure of care gapsTranslate clinical and operational needs into clear business and system requirementsAssist in the measurement and reporting of care outcomes, quality metrics, and utilization trendsConduct stakeholder interviews, workshops, and current‑state/future‑state process analysisDevelop Business Requirement Documents (BRDs), Functional Requirement Documents (FRDs), process flows, and user storiesSupport system enhancements, integrations, and data initiatives related to provider and care management platformsValidate solutions through UAT planning, execution, and defect triageAnalyze healthcare data related to cost, utilization, quality, risk stratification, and provider performanceSupport reporting for regulatory and accreditation requirements (e.g., CMS, NCQA, state mandates)Ensure alignment with healthcare standards such as ICD‑10, CPT, HCPCS, HEDIS, and FHIR where applicableSkills6–10+ years of experience as a Business Analyst in healthcareStrong hands‑on experience with Provider Network operations and Care Management programsExperience working with payer systems or healthcare platforms supporting network and care management functionsProvider contracting, credentialing, and directory managementCare Management, Utilization Management, Case/Disease Management modelsValue‑Based Care, ACOs, and quality improvement initiativesUnderstanding of payer workflows and end‑to‑end member/provider lifecycleRequirements elicitation and documentation (BRD, FRD, user stories)Process modeling tools (Visio, Lucidchart, BPMN)Agile and/or Waterfall delivery methodologiesData analysis using SQL, Excel, or BI tools (reported or self‑service)Familiarity with healthcare platforms such as care management systems, provider data systems, and claims platformsStrong communication skills with clinical, business, and technical stakeholdersAbility to translate complex clinical and operational concepts into actionable requirementsAnalytical mindset with strong problem‑solving capabilitiesProven ability to manage multiple priorities in a fast‑paced environmentExperience supporting HEDIS, Stars, Risk Adjustment, or Quality programsExposure to FHIR‑based integrations and healthcare interoperability initiativesCertification such as CBAP, CCBA, or PMI‑PBAExperience in payer modernization or digital health transformation initiativesBenefitsHealth, dental, vision, life insurance, and disability plansCompany 401(k) Plan11 paid holidays12 weeks of Parental LeaveFree time PTO policyCompany OverviewFractal is an AI firm with the aspiration to power every human decision in theenterprise. It was founded in 2000, and is headquartered in Mumbai, Maharashtra, IND, with a workforce of 5001-10000 employees. Its website is http://www.fractal.ai.