Business System Analyst â Digital health

Business System Analyst – Digital Health

CGI is seeking a Digital Health Business Systems Analyst to serve as a strategic and hands‑on implementation partner within a healthcare payer organization. This role will drive the end‑to‑end evaluation, onboarding, and operational integration of digital health vendor solutions belonging to a growing portfolio of point solutions across musculoskeletal health, behavioral health, chronic disease management, remote patient monitoring, and wellness. Vendors include Hinge Health, Omada, Livongo, Sword Health, Calm, Teladoc, Brightline, and others.

The analyst will translate clinical program goals and payer operations requirements into technical specifications, data‑exchange designs, and vendor accountability frameworks. Collaboration with clinical, network, IT, product, compliance, and vendor teams is essential to ensure each solution is implemented on time, within scope, and delivers measurable member and business outcomes. The position requires working from the client site in Canton, MA and will be hybrid in nature.

• Partner with clinical, product, and finance teams to define requirements for new digital health point solutions, including scope, target population, eligibility criteria, and integration needs.
• Conduct demos, due diligence sessions, and reference checks with prospective vendors; synthesize findings into executive‑ready recommendations.
• Assess vendor data security posture, HIPAA compliance, SOC 2 certification, and interoperability capabilities (FHIR, HL7, API‑first vs. flat‑file) as part of selection criteria.
• Maintain a living digital health vendor landscape map, tracking competitive landscape, emerging solutions, and market‑moving clinical evidence.

• Lead end‑to‑end implementation of digital health vendor solutions, serving as the primary business and technical liaison between the health plan and vendor project teams.
• Define project scope, work streams, milestone plans, RACI matrices, and risk registers for each vendor implementation.
• Facilitate discovery workshops with internal stakeholders (IT, clinical, network, member services, compliance) to capture current‑state workflows and future‑state requirements.
• Translate business and clinical requirements into detailed functional specifications, data mapping documents, and integration design artifacts.
• Oversee and execute UAT planning, test script development, defect tracking, and go/no‑go sign‑off processes.
• Manage phased rollout strategies including pilot populations, eligibility file configurations, member outreach sequencing, and benefit design alignment.

• Own data exchange design for all vendor integrations including eligibility feeds (834/custom), claims data sharing, clinical data (FHIR R4, HL7 2.x), and outcomes reporting files.
• Partner with IT/data engineering teams to design, test, and validate automated eligibility, enrollment, and disenrollment workflows for each vendor platform.
• Ensure data governance standards are applied across integrations including PHI handling, data minimization, and audit logging.
• Troubleshoot and resolve data feed issues, transformation errors, and reconciliation discrepancies in production environments.
• Support Single Sign‑On (SSO) and API integration design between the member portal, mobile app, and vendor platforms.

• Partner with benefits design and actuarial teams to translate digital health benefit structures into vendor‑specific eligibility and access configurations.
• Manage eligibility cohort definitions, suppression logic, and override workflows across the vendor portfolio.
• Ensure alignment between vendor eligibility configurations and plan benefit package (PBP) structures for Medicare Advantage, Commercial, and Medicaid lines of business.
• Coordinate with member services on member‑facing communication content, escalation pathways, and digital health program FAQs.

• Ensure all digital health solutions comply with applicable regulatory requirements including CMS…