Business Analyst - Clinical Operations and Clinical Quality

This Business Analyst position is specifically focused on clinical operations and clinical quality , including utilization management, care management, medical management, population health, benefit reviews, and system configuration. The role is responsible for gathering and documenting internal and client-facing workflows tied to clinical operations and administration, and care delivery based on the benefits offered by the plan. The analyst will review artifacts for alignment with documented contract and program requirements, identify gaps between operational plans vs. requirements, and will work closely with subject matter experts and leadership to translate operational concepts into clear documentation, process maps, and support materials. Additional responsibilities include reviewing benefit policies and procedures for accuracy and documenting necessary updates. Key Responsibilities: • Meet with clients to gather operational and functional requirements, document processes, dependencies, and decision points in real time. • Review documentation to ensure they meet contract or program requirements. This may include policies and procedures documents, requirements documents, clinical policy documents, user stories, test results, and benefits. • Review benefit policy and procedure documents for accuracy and incorporate updates into requirements documentation • Collaborate with proposal teams to develop storyboards and solution frameworks aligned to government RFPs (requests for proposal) and program requirements. • Participate in internal kickoff meetings, brainstorming sessions, and review cycles to refine solution narratives and ensure alignment with client objectives. • Contribute to the development of standard operating procedures (SOPs), internal playbooks, staffing models, and other pre- and post-award materials. • Serve as the central point of contact for assigned projects—facilitating communication between clients, internal teams, and vendors. • Assist with the development of SOPs, internal playbooks, and proposal content as needed to support contract growth or onboarding. • Support general administration and compliance oversight, including reporting, and quality control.