CGI · 8 hours ago
Senior Business System Analyst - Healthcare
Canton, MA
Full-time
Hybrid
Senior Level, Lead/Staff
$88K/yr - $153K/yr
8+ years expCGI is a leading IT and business consulting services firm, and they are seeking a Senior Business System Analyst to drive interoperability initiatives for healthcare payer organizations. The role involves implementing solutions aligned with CMS and ONC mandates, enhancing data exchange capabilities, and collaborating with cross-functional teams to ensure efficient interoperability implementations.
AnalyticsApplication Performance ManagementBusiness IntelligenceConsultingCyber SecurityFinanceInformation TechnologyTechnical Support
Hiring Manager
Michelle Podinker
Responsibilities
Gather, document, and validate business and technical requirements for interoperability solutions such as FHIR APIs, Member Access APIs, Provider Directory APIs, Payer-to-Payer Data Exchange, and Prior Authorization APIs
Analyze CMS/ONC regulations (e.g., CMS Interoperability & Patient Access Rule, CMS Prior Authorization Rule, TEFCA-related requirements) and translate them into actionable system requirements
Support gap analysis for existing payer systems (claims, clinical data, provider, member, authorization) to determine interoperability readiness
Develop functional specifications, user stories, acceptance criteria, and process workflows for interoperability implementations
Work with architects and engineers to define data mapping, transformation logic, and API interaction models aligned with HL7 FHIR standards
Ensure solutions integrate effectively with enterprise systems such as claims adjudication, enrollment, provider management, UM/PA, care management, and data warehouses
Perform data profiling and mapping for clinical and administrative datasets (e.g., EDI 837/835, 270/271, CCDA, FHIR resources)
Support test case development, test planning, and execution for API validation, edge-case handling, and compliance testing
Ensure data accuracy, completeness, and compliance with security and privacy standards (HIPAA, PHI/PII handling)
Serve as the liaison between business stakeholders and technical teams, ensuring alignment on requirements, scope, and delivery timelines
Participate in sprint planning, backlog grooming, and solution demonstrations as part of Agile/Scrum teams
Provide subject matter expertise (SME) on payer workflows such as claims processing, member onboarding, provider data management, care management, and prior authorizations
Qualification
Required
8-10 years of experience as a Business Analyst or Business Systems Analyst in the healthcare payer domain
Strong understanding of FHIR standards, HL7, EDI transactions, and healthcare information exchange models
Hands-on experience with interoperability implementations, preferably CMS-mandated FHIR APIs or payer modernization initiatives
Working knowledge of healthcare payer systems and processes (benefits, claims, enrollment, provider data, UM/PA)
Experience writing business, functional and technical specs, data mapping documents, and business process flows
Strong analytical, problem-solving, and communication skills
Benefits
Competitive compensation
Comprehensive insurance options
Matching contributions through the 401(k) plan and the share purchase plan
Paid time off for vacation, holidays, and sick time
Paid parental leave
Learning opportunities and tuition assistance
Wellness and Well-being programs
Company
CGI
CGI is an IT and business consulting services firm that offers consulting, cyber security, cloud, and IT services.
10001+ employees
H1B Sponsorship
CGI has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (775)
2024 (762)
2023 (795)
2022 (940)
2021 (846)
2020 (582)
Funding
Current Stage
Public CompanyTotal Funding
$1.2B2025-03-12Post Ipo Debt· $650M
2024-09-03Post Ipo Debt· $550.87M
1998-10-06IPO
Leadership Team
François Boulanger
President and Chief Executive Officer at CGI
Raymond McMann
VP, Global Oil & Gas Industry
Recent News
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