Compliance Data Mapping - Systems Analysis Sr Advisor

Qualcare - Nashville, TN

Full-time - Mid Level

Hybrid - Nashville, TN

Ambulatory Health Care Services

About the position

The Systems Analysis Senior Advisor at Qualcare, Inc. plays a crucial role within the Agile Team, acting as a bridge between the team and the business. This position is responsible for defining the vision, scope, and priorities of detailed requirements, ensuring that user stories are aligned with business needs. The advisor will work closely with various stakeholders to refine features and user stories, manage the team backlog, and ensure the quality of the product delivered by the team. A strong understanding of CMS Interoperability and data management specific to Medicare is essential, along with the ability to guide the team on story estimates and sequencing.

Responsibilities

• Work with FHIR SME to understand Interoperability data mapping specification requirements
• Complete FHIR mapping documents in collaboration with data SMEs
• Document data mapping specifications from MA sources to standard target profiles (STTM)
• Attend FHIR Forums to review data mapping specification to ensure alignment
• Conduct walk-through of data mapping specifications with engineering team
• Support engineering team for issues, clarification, and execution
• Create, manage, and execute the Interoperability UAT Strategy
• Facilitate source business owner review sessions and plan/execute E2E, integration, and data quality validations
• Collaborate with the business, compliance, and cross functional IT stakeholders to define a roadmap that clearly defines the priorities and business value for government business segment
• Serve as product owner as part of an Agile team
• Understand compliance and business priorities and convert them to Features, User Stories and Technical Designs to build and prioritize the product backlog for sprint teams
• Work with Sprint or Kanban teams on a daily basis in providing inputs on user stories and removing road blocks
• Provide leadership for scrum meetings, backlog grooming, sprint planning and sprint demos
• Provide timely communication of progress and blockers
• Provide linkage and continuity to business units, development, operations and technical support groups in the testing and implementation of recommendations
• Act as an expert resource to client and development management and staff in all phases of the development and implementation process
• Perform data related investigations, track lineage and quality issues, review data layout and structures
• Provide support in Production issue/defect resolution

Requirements

• Experience implementing CMS Interoperability compliance requirements
• Knowledge of CMS Interoperability solutions and FHIR Implementation Guides and Standards
• Experience implementing Compliance requirements within Healthcare
• Extensive experience with data management, data governance and data quality
• Understand the source to target mapping of each mapped element as defined by the Structure Definition
• Familiarity with Healthcare industry domains
• Self-driven and able to function with minimal direction from Manager
• Ability to engage business and data stakeholders to resolve questions or issues
• Ability to handle multiple and sometimes competing priorities in a fast-paced environment
• Quick learner and a team player
• Expert in Agile Methodology and previous experience as a product owner for Agile teams

Nice-to-haves

• 5+ years of experience in data analysis, business and technical requirements gathering, product owner, backlog management, process documentation, user facing, and excellent written and verbal communication skills
• Ability to be innovative and creative with solutions that frequently involve multiple platforms, software, hardware, technologies and tools
• Ability to learn the entire end-to-end process, including any handoffs, in order to make solution recommendations to business partners
• Logical reasoning and attention to detail skills
• Experience with Medicare including Medicare Advantage and Medicare supplemental benefits
• Experience with payer solutions in the healthcare industry
• Familiarity with Cloud platforms such as AWS

Benefits

• Medical insurance
• Vision insurance
• Dental insurance
• Well-being and behavioral health programs
• 401(k) with company match
• Company paid life insurance
• Tuition reimbursement
• Minimum of 18 days of paid time off per year
• Paid holidays