Business Analyst

Business And Data Analyst Healthcare Interoperability

We lead the industry in the breadth and depth of how we support our customersby becoming an extension of their internal team. Helping our customers deliver world-class care and service is the Professional Services Team. The Professional Services team is seeking Business and Data Analyst Healthcare Interoperability with strong expertise in healthcare interoperability to support large volume data-driven initiatives that improve healthcare data exchange and integration. This role will focus on understanding complex data setsincluding member, claims, provider, clinical, and enrollment dataextracted from multiple source systems and spread across multiple data files. The analyst will assess data integrity, identify bad or incomplete data, map relationships between data elements, uncover patterns for process automation, and simplify integration between disparate healthcare platforms. Roles and Responsibilities include acting as a liaison between business stakeholders, technical teams, and application users to analyze workflows, translate data requirements, and ensure compliance with healthcare standards such as HL7, FHIR, CCD, and X12.

Responsibilities

• Analyze business needs related to healthcare data exchange and interoperability workflows.
• Interpret and document healthcare data (HL7, FHIR, CDA, CCD, X12, etc.) specifications for development and integration teams.
• Interpret and document data integrity issues, bad data patterns, missing values, and duplication.
• Map and transform healthcare data into standardized formats (HL7 v2, HL7 FHIR, X12 EDI, CCD / C-CDA, proprietary formats).
• Collaborate with internal and external stakeholders to gather data requirements and define technical specifications.
• Work with teams to design streamlined, automated processes for exchanging data between payer, provider, and third-party systems.
• Ensure solutions comply with HIPAA, CMS interoperability rules, ONC guidelines, and other regulatory requirements.
• Partner with product managers, architects, and developers to ensure interoperability solutions meet business needs.
• Develop and execute test cases for data transformations and integrations.
• Validate that data outputs align with both business rules and technical specifications.
• Validate data accuracy and integrity across systems using SQL and data profiling tools.
• Assist in root cause analysis and resolution of integration or data quality issues.
• Support UAT (User Acceptance Testing) for interoperability solutions and work with QA teams on test planning and validation.
• Assist development team with performance analysis and testing during release cycles for service packs, hot fixes, etc.
• Deliver a consistent, responsive, and satisfying customer experience with each project.

Qualifications

Base compensation ranges from $76,000 to $94,000 per year. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs.

Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(k) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti. For information about our benefits package, please refer to our Careers page.