About Lumen Solutions
Sourced by ZipRecruiter
Company size
11 - 50 Employees
Headquarters location
Sterling, VA, US
Year founded
1998
Contractor
Posted 15 days ago
Job description
Company Description
Lumen Solutions Group Inc. is a technology consulting Services company based in Florida. We provide a wide array of experienced business and IT professionals supporting clients from solution design to implementation and support. We specialize in professional IT consulting services, IT Staffing, Business/IT Strategy, Business Process Blueprints, Enterprise Architecture, Enterprise Transformation.
Role: Lead Business Analyst (Clinical Background)
Location: Reston VA - 100% Remote
Job Type: Contract
Job Summary:
We are seeking a Lead Business Analyst (Clinical) with strong healthcare domain expertise to drive business requirements, utilization management initiatives, and end-to-end business testing. This role will work closely with business, IT, and testing teams to ensure successful delivery of clinical and prior authorization solutions aligned with regulatory mandates.
Key Responsibilities:
- Lead business requirements gathering and documentation for clinical systems.
- Drive Utilization Management (UM) and Prior Authorization initiatives.
- Ensure end-to-end requirements traceability.
- Manage and support business testing and test remediation lifecycle.
- Collaborate with business, IT, and QA teams for project delivery.
- Lead RAID tracking, dependencies, and weekly project status reporting.
- Support provider onboarding and business readiness activities.
- Participate in large stakeholder meetings and drive discussions.
- Utilize tools like Jira for tracking and reporting.
- Work with PAS (Prior Authorization System) and integrated platforms.
- Bachelor’s degree or equivalent experience.
- 10+ years of experience as a Business Analyst in healthcare.
- Strong experience with Prior Authorization and Provider Data.
- Hands-on experience with Utilization Management (UM) and Clinical Operations.
- Clinical background with knowledge of CMS-0057F mandate.
- Experience with Medicare, Medicaid, and BCBSA plans.
- 2+ years of experience with GuidingCare or similar platforms (GIBA, Medecision).
- Strong experience in business testing and requirements traceability.
- Excellent communication and stakeholder management skills.
- Strong experience with Jira.
- Experience with DTR/MCG platform integration.
- Knowledge of PAS (Prior Authorization System) workflows.
- Experience in project management and RAID tracking.
- Familiarity with SDLC, test strategies, and quality assurance processes.
- Experience with databases and query languages.
- Strong analytical and problem-solving skills.
- Experience in Agile environments.
Lumen Solutions Group Inc is an equal opportunity employer. All qualified applicants will be considered for employment without regard to any legally protected status.
lumensolutions.com
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Frequently asked questions
Q: What skills or qualities help someone succeed as a Lead Business Analyst?
A: To succeed as a Lead Business Analyst, key technical skills include proficiency in business analysis methodologies (e.g., BABOK), data analysis tools (e.g., Excel, SQL), and project management software (e.g., Agile, Scrum). Essential soft skills include strong communication and interpersonal skills, the ability to build trust and rapport with stakeholders, and effective problem-solving and conflict resolution skills. By combining these technical and soft skills, a Lead Business Analyst can drive business growth, improve process efficiency, and foster a collaborative work environment, ultimately supporting their career advancement and professional effectiveness.
Q: What is the career path for a Lead Business Analyst?
A: A Lead Business Analyst's typical career progression involves starting as a Business Analyst, then advancing to Senior Business Analyst, and eventually leading to a Lead or Managerial role, overseeing multiple projects and teams. Key opportunities for skill development include mastering business acumen, technical skills, and project management methodologies, as well as developing leadership and communication skills to effectively guide teams and stakeholders. Long-term career prospects for a Lead Business Analyst may include transitioning into executive roles, such as Director of Business Analysis or IT, or pursuing specialized roles like Product Management or Strategy Consulting.
