Solution Business Analyst (Medicare/Medicaid Expertise)

G3. GG Tech Global is seeking a healthcare-focused Solution Business Analyst to bridge business strategy, healthcare operations, and AI technologies. The role reimagines clinical, operational, and administrative processes, architects AI-enabled healthcare solutions, ensures compliance and ethical AI usage, and leads business analysts and quality analysts on customer engagements.

Responsibilities:

• Lead process reimagination initiatives across healthcare domains
• Identify inefficiencies and design future-state AI-enabled workflows
• Architect end-to-end AI-driven healthcare solutions
• Ensure regulatory compliance and ethical AI usage
• Collaborate with clinicians, business leaders, and technology teams

Requirements:

• 5+ years in Architecting business solutions
• overall IT exp of 10+ years in Business Analysis in Healthcare domain
• health plan domains like- claims, membership, provider network, UM/CM, payment models
• end to end claim cycle for all the LOBs (commercial, Medicare, Medicaid, marketplace)
• how AI can be leveraged
• produce enterprise level business design/system requirements aligned to NTT DATA's product vision
• lead a team of BAs and QAs for customer engagements
• Bachelor's or Master's degree in relevant fields
• 8–10+ years of healthcare or digital transformation experience
• Proven experience with AI-enabled healthcare solutions (3+ years)
• Strong stakeholder and communication skills
• Experience with EHR systems
• Knowledge of HL7, FHIR standards
• Cloud healthcare AI experience
• Architecture or healthcare certifications