Business Analyst Provider Credentialing (AI-Enabled Healthcare Platforms)
hace 16 días
East Brunswick
Job DescriptionSalary: About Us: Atlas Systems Inc. is a Software Solutions company headquartered in East Brunswick, NJ. Incorporated in 2003, Atlas provides comprehensive range of solutions in the area of GRC, Technology, Procurement, Healthcare Provider and Oracle to customers across the globe. Combining our unparalleled experience of over a decade in the software industry and global reach, we have grown with extensive capabilities across industry verticals. For more information, please visit our website Please click on the link below to apply for this position Job Title Contract Business Analyst Provider Credentialing (AI-Enabled Healthcare Platforms) Engagement Type Contract / Short-Term (Immediate Start) Location: Remote Duration: 812 weeks (estimated, based on scope) Start: Immediate Overview We are seeking a highly experienced Business Analyst with deep domain expertise in Provider Credentialing and strong working knowledge of AI-enabled product design to lead a defined, outcome-driven engagement. The objective of this role is not to design another credentialing system, but to reimagine provider credentialing using AI, automation, and intelligent workflowswhile remaining grounded in real-world payer and provider operations. This role owns the functional vision end-to-end: • Conceptualizing disruptive, AI-assisted workflows, • Designing high-fidelity Figma UI/UX 1. AI-Forward UX & Workflow Design • Design high-fidelity Figma screens that depict:, • Provider credentialing workflows for Health Systems, • Provider credentialing workflows for Health Plans, • Reimagine traditional credentialing processes using:, • AI-assisted data ingestion and normalization, • Intelligent task prioritization and exception handling, • Reduced manual touchpoints and zero-click workflows where feasible, • Cover core and advanced use cases:, • Initial credentialing and onboarding, • Re-credentialing and continuous monitoring, • Primary Source Verification (PSV), • Delegated credentialing, • Exception handling, expirations, and audit readiness, • Clearly model:, • Human-in-the-loop vs AI-driven decisions, • Confidence scoring, explainability, and review flows, • Alerts, recommendations, and proactive interventions 2. Disruptive Use Case Definition • Identify opportunities where AI can materially change:, • Time to credential, • Cost per provider, • Manual effort and rework, • Audit and compliance burden, • Ensure the solution:, • Goes beyond digitizing existing workflows, • Challenges legacy assumptions in credentialing operations, • Differentiates clearly from incumbent credentialing platforms 3. Functional & Business Documentation • Produce engineering-ready artifacts, including:, • End-to-end use cases and workflow narratives, • User stories with clear acceptance criteria, • Functional requirements mapped to UI and AI behaviors, • Edge cases, fallback scenarios, and exception handling, • Clearly document:, • Where AI augments human decision-making, • Where deterministic rules still apply, • Guardrails for compliance, accuracy, and auditability 4. API, Data & Intelligence Flow Interpretation • Review and interpret API documentation from primary credentialing data sources (e.g., CAQH, NPI, state boards, sanctions, exclusions), • Identify and document:, • Which APIs are invoked at each stage of the workflow, • Event-driven vs on-demand data pulls, • How AI layers consume, enrich, and reason over source data Provider Credentialing Domain Expertise (Must-Have) • Deep, hands-on experience with:, • Health System credentialing operations, • Health Plan / payer credentialing workflows, • Primary Source Verification (PSV), • Regulatory and compliance considerations, • Strong working knowledge of:, • AI/ML-enabled enterprise products, • Generative AI and intelligent automation concepts, • Ability to:, • Identify where AI creates real operational leverage, • Avoid AI for AIs sake, • Design explainable, compliant, and auditable AI-assisted workflows, • Proven experience designing enterprise-grade UX in Figma, • Strong product thinkingable to connect business outcomes to UX and system behavior, • Comfortable interpreting API specifications and mapping them to workflows, • 8+ years as a Business Analyst / Product Analyst / Product Manager in healthcare technology, • Experience spanning:, • Payers and provider organizations, • Platform or product-led healthcare solutions, • Operate independently with minimal oversight, • Drive clarity in ambiguous problem spaces, • Balance innovation with regulatory realism, • Opportunity to reshape how provider credentialing is done, not just improve it, • High-impact engagement with clear ownership, • Direct influence on a next-generation, AI-enabled healthcare platform