Business Solution Manager

This is a fully remote position, open to applicants in United States.

📋 Description

• Take ownership of the Requirements-to-Design Arc.

• Facilitate discovery sessions with client subject matter experts to delve into the underlying reasons and objectives of each use case: understanding the business context, pain points, expected outcomes, and success criteria, rather than merely addressing superficial data requests.

• Convert each use case into a detailed set of clear, testable requirements, incorporating the success criteria and non-functional requirements that outline what constitutes completion, ensuring complete traceability from business need to requirement.

• Clearly document the requirements for the client and downstream teams, and then convert them into a design that developers can implement: detailing the source-to-target data flow, transformation logic, and business rules necessary to achieve the intended output.

• Assess the appropriate granularity and structure of a dataset within the business context, ensuring the design addresses the actual question rather than providing an approximation — and trace how this granularity decision impacts every downstream report, model, or program using the data.

• Identify dependencies before finalizing a design: which additional workstreams, reports, or client use cases interact with this data, and how changes here could either disrupt or enhance their functionality.

• Adopt systems thinking as a standard practice, recognizing instances where a design created for one client, state, or use case can evolve into a reusable pattern, and actively design for that reuse rather than discovering it retrospectively.

• Engage in Hands-On Data Work.

• Write and execute SQL to analyze and investigate data, test assumptions, and prototype during requirements and design phases. Hands-on data work is fundamental to this role, not just an occasional task.

• Serve as the Client-Facing Anchor.

• Lead requirements-gathering and clarification discussions with clients, as incomplete or poorly articulated requirements can compromise everything developed downstream.

• Represent client intent throughout the engagement and remain a consistent point of contact during delivery.

• Translate effectively between business and technical audiences, ensuring both sides maintain a shared understanding.

• Collaborate Across Delivery.

• Act as the central link between the client and the internal team, maintaining the business context and design influences that shape the development process.

• Function as the client's subject matter expert for Solution Architects, Product, QA, Account Management, and Program Management, providing them with clear hand-offs that include the necessary context, business rules, and logic to execute without rework or misinterpretation.

• Maintain an overarching perspective across a multi-workstream engagement: comprehend how decisions made for one workstream impact others, and proactively highlight those ripple effects before they lead to rework.

⛳️ Requirements

• Bachelor's degree or equivalent relevant experience.

• 3+ years of experience in the US healthcare sector and working with healthcare data (claims, provider, membership/eligibility, benefits, prior authorization, or PBM).

• Required payer experience — direct involvement working with or for a US health plan (Medicare, Medicaid, or Commercial), whether in-house or through healthcare consulting.

• Proficient understanding of core payer concepts such as membership/enrollment, provider, claims, and authorizations, enabling reasoning about business context rather than specializing narrowly in any single area.

• Capable of writing and executing SQL to analyze, explore, and prototype with data. SQL proficiency is essential; familiarity with Databricks or Snowflake is a plus. This differs from a software or data engineering background.

• Experience in eliciting and authoring business requirements within complex, data-driven environments.

• Strong client-facing communication skills; capable of steering conversations and clearly eliciting requirements.

• Comfortable navigating ambiguity and frequently re-prioritizing tasks across a large, multi-workstream engagement.

• Proven systems thinking: a history of designing for reuse and scalability across states, clients, or use cases rather than addressing each case in isolation — able to trace how a single requirement or data model decision influences other components of a larger data ecosystem and evaluate those second-order effects when making design trade-offs.

🏝️ Benefits

• Unlimited paid time off – recharge when you need it.

• Work from anywhere – flexibility to fit your life.

• Comprehensive health coverage – multiple plan options to choose from.

• Equity for every employee – share in our success.

• Growth-focused environment – your development matters here.

• Home office setup allowance – one-time support to get you started.

• Monthly cell phone allowance – stay connected with ease.