Clinical Business Analyst

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

📋 Description

• Act as a Subject Matter Expert for InfoMC’s applications related to utilization management and care management.

• Offer expert advice on UM/CM solutions and address clinical challenges.

• Partner with product management, development, and implementation teams to propose system improvements.

• Create and present training sessions for staff and clients on new features, AI-enhanced tools, and clinical workflows.

• Play a role in the design, testing, and documentation of clinical initiatives.

• Support sales teams with lead generation, pre-sale assessments, and product demonstrations.

• Generate documentation on product configurations, clinical workflows, and best practices.

• Diagnose and resolve client issues, ensuring satisfaction and adherence to regulatory standards.

• Keep up-to-date with trends in healthcare IT, clinical practices, and regulatory changes.

⛳️ Requirements

• Over 5 years of clinical experience within payer or integrated health systems, with specific expertise in UM/CM.

• More than 2 years in the healthcare software sector, ideally with UM/CM platforms.

• Registered Nurse (RN) or a licensed healthcare professional with clinical experience.

• Degree in Nursing (RN) or a related healthcare discipline.

• Possession of advanced certifications like CCM or CPUM.

• In-depth knowledge of clinical practices, federal and state regulations, CMS, HIPAA, and payer programs.

• Familiarity with Medicare Advantage and Managed Medicaid is preferred.

• Experience with healthcare IT systems, AI-driven analytics, FHIR-compliant interoperability, and provider portal integration.

• Outstanding analytical and conceptual thinking abilities.

• Excellent presentation and interpersonal communication skills.

• Must be authorized to work in the U.S.; sponsorship is not available.

🏝️ Benefits

• A culture recognized as the Best Place to Work.

• A people-first approach to workplace culture.

• Ongoing investment in team and individual development.

• Option for remote work arrangements.