Healthcare Analyst Visa Sponsorship Jobs in Pennsylvania

Role Overview

The Lead Business Systems Analyst leads business analysis and data exchange initiatives in the Data Integration Department within our Enterprise Data Office, with a strong focus on HL7 standards (FHIR, CCD, ADT, SIU) to ensure regulatory compliance (CMS, ONC) and data integrity. The position requires deep healthcare data expertise and the ability to independently drive requirements, translate business needs into technical specifications, partner closely with IT teams, and mentor junior Business Analysts.

Work Arrangement

• This is a hybrid, office based position at our Ellis Preserve office located in Newtown Square, PA.
• Core office days are Tuesday, Wednesday, and Thursday; remote days are Monday and Friday.
• We will not consider Remote candidates for this position.

Responsibilities

• Lead requirements end to end, independently driving discovery, analysis, and solution definition across business and IT stakeholders.
• Serve as a subject matter expert on CMS Interoperability and HL7 exchange protocols, including FHIR, CCDs, ADTs, etc.
• Perform hands on data analysis using SQL, Databricks, and related tools to validate data, troubleshoot issues, and support design decisions.
• Document business and technical requirements, source to target mappings, data specifications, business rules, and process flows.
• Support validation and QA by reviewing data outputs, test cases, and results to ensure accuracy and compliance.
• Collaborate with internal teams and external partners with minimal supervision to gather requirements, drive key decisions, and support successful implementations.
• Mentor and guide junior BAs on best practices in requirements, documentation, analysis, and stakeholder engagement.
• Communicate business and process solutions, recommendations, and issues to ACFC management on a regular basis.
• Document all business process flows related to interoperability initiatives.
• Apply working knowledge of ACFC Managed Care functions (HealthCare Services, Claims, Enrollment, Quality/HEDIS, Risk Adjustment, Care Management, Utilization Management) to support problem solving and solution design.
• Provide strong communication and status updates to business and IT stakeholders and management.
• Build consensus among users, IT, and senior leadership on business problems and solution approaches.
• Address most inquiries independently, escalating only when appropriate.
• Ensure requests are addressed promptly, professionally, and with persistence in gathering required information.
• Meet with external vendors to evaluate products and ensure ACFC requirements are met.
• Communicate effectively with senior and mid level management.
• Understand chain of command, decision making roles, and communicate accordingly.
• Demonstrate strong analytical and problem solving skills, including evaluating alternatives, recommending solutions, and articulating impacts.
• Make sound decisions with minimal direction and apply appropriate approaches to each situation.
• Respond promptly to requests related to budgets, operational objectives, reporting, process re-engineering, and business flows.
• Produce clear, well structured written and verbal communications.
• Brief management appropriately when issues require senior level attention.
• Maintain regular communication with management and keep staff informed of progress, risks, and priorities.

Education and Experience

• At least five to ten (5 – 10) years of experience in healthcare IT, data integration, or business analysis.
• Experience with FHIR, HL7 clinical data exchange standards (CCD/ADT/SIU) and healthcare terminology (LOINC, ICD 10, CPT, etc.).
• Ability to interpret large datasets and deliver evidence based recommendations.
• Strong organizational, analytical, and interpersonal skills.
• Ability to communicate effectively at all organizational levels.
• Advanced proficiency with Microsoft Office Suite.
• Proficiency in SQL, Databricks, and data validation techniques.
• Experience in Agile Delivery with usage of tools like Azure DevOps or JIRA.
• General knowledge of healthcare operations (HEDIS, Prior Authorizations, etc.) in a managed care environment.
• Demonstrated ability to work independently and collaboratively.
• Strong documentation, communication, and problem solving skills.
• Bachelor’s degree or equivalent experience.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, competitive pay, paid time off including holidays and volunteer events, health insurance coverage for you and your dependents on Day 1, 401(k), tuition reimbursement and more.

Your career starts now. We're looking for the next generation of health care leaders.

At AmeriHealth Caritas, we're passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we'd like to hear from you.

Headquartered in Newtown Square, PA, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.