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Clinical Business Analyst

Vaco
$60.00 - $74.00 / hr
United States, Ohio, Blue Ash
Jan 30, 2025

We are seeking aClinical Business Analyst (BA) with experience in Care Management (CM) and Utilization Management (UM). The BA will act as a bridge between business and IT, supporting new market implementations and expansions.
  • Role Focus: Not highly technical but must understand clinical processes.
  • Work Model: Primarily remote, minimal travel.
  • Contract Duration: Long-term (through 2026+)
Key Responsibilities
1. Care Management & Utilization Management Support
  • Care Management:
    • Manage incoming data related to outreach and reporting.
  • Utilization Management (UM):
    • Handle authorization processing from providers.
    • Manage pending reviews, auto-approvals, and communication with the state.
    • Work with FACETS on file exchanges and authorization decisions.
  • IMO (Implementation & Market Operations) Initiatives:
    • Support new markets, expansions, and partnerships.
2. Reporting & Functional Alignment
  • Work closely with IMO team PMs:
    • Lead BA evaluates new contracts in the market.
  • Use Azure DevOps (ADO) for managing work.
  • Collaborate with business, product owners, and analysts to align requirements with IT and reporting teams.
Key Candidate Assessment Questions
Candidates should be able to break down an epic from the business (e.g., "Manage clinical for the state of Wisconsin, automate encounter data intake") and define actionable features for IT.
BA Role in Utilization Management
  • Work across five key epics:
    • Receiving/utilizing UM data.
    • Extracting data from the provider portal.
    • Developing epics to automate UM processes.
    • Configuring systems for UM functions.
    • Reporting on UM activities.
Required Skills & Qualifications
1. Core BA Skills
  • Strong consulting and analytical skills.
  • Proactive, confident, and able to ask the right questions.
  • Ability to work independently without hand-holding.
  • Clearly articulate business requirements for IT teams.
2. Stakeholder Engagement & Communication
  • Escalate when business owners are unavailable.
  • Work with Solution Architects (SAs), Product Owners (POs), and IT teams.
  • Be assertive in distinguishing business vs. technical requirements.

Vaco values a diverse workplace and strongly encourages women, people of color, LGBTQ+ individuals, people with disabilities, members of ethnic minorities, foreign-born residents, and veterans to apply.

EEO Notice

Vaco is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race (including but not limited to traits historically associated with race such as hair texture and hair style), color, sex (includes pregnancy or related conditions), religion or creed, national origin, citizenship, age, disability, status as a veteran, union membership, ethnicity, gender, gender identity, gender expression, sexual orientation, marital status, political affiliation, or any other protected characteristics as required by federal, state or local law.

Vaco LLC and its parents, affiliates, and subsidiaries are committed to the full inclusion of all qualified individuals. As part of this commitment, Vaco LLC and its parents, affiliates, and subsidiaries will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact HR@vaco.com .

Vaco also wants all applicants to know their rights that workplace discrimination is illegal.

By submitting to this position, you agree that you will be giving Vaco the exclusive right to present your as a candidate for the foregoing employment opportunity. You further agree that you have represented information about yourself accurately and have not affirmatively misrepresented your qualifications. You also agree to maintain as confidential, to the fullest extent permitted by law, any information you learn from Vaco about the position and you will limit disclosure of information about the position only to the extent necessary to perform any obligations in furtherance of your application. In exchange, Vaco agrees to exercise reasonable efforts to represent you through all solicitation, job screening and resume dispersal.

Privacy Notice

Vaco LLC and its parents, affiliates, and subsidiaries ("we," "our," or "Vaco") respects your privacy and are committed to providing transparent notice of our policies.

  • California residents may access Vaco's HR Notice at Collection for California Applicants and Employees here.
  • Virginia residents may access our state specific policies here.
  • Residents of all other states may access our policies here.
  • Canadian residents may access our policies in English here and in French here.
  • Residents of countries governed by GDPR may access our policies here.
Pay Transparency Notice

Determining compensation for this role (and others) at Vaco depends upon a wide array of factors including but not limited to:

  • the individual's skill sets, experience and training;
  • licensure and certification requirements;
  • office location and other geographic considerations;
  • other business and organizational needs.

With that said, as required by local law, Vaco believes that the following salary range referenced above reasonably estimates the base compensation for an individual hired into this position in geographies that require salary range disclosure. The individual may also be eligible for discretionary bonuses.

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