Sr Business Analyst

Ampcus Inc. is a certified global provider of a broad range of Technology and Business consulting services. We are in search of a highly motivated candidate to join our talented Team.

Eden Prairie, MN (Local to MN)

• Ambulatory Optum is seeking a highly experienced healthcare business analytics and methodology subject matter expert to support the design, validation, and evolution of analytic solutions for hospitals, ambulatory settings, and cross-continuum care.
• This role is focused on translating complex healthcare quality, utilization, patient safety, and regulatory measure concepts into market-ready analytic methodologies, documentation, and product guidance.
• The ideal candidate will bring deep expertise in CMS quality programs, healthcare data structures, benchmarking logic, and measure feasibility across claims, billing, encounter, and EHR/EMR-based data environments.
• As a key member of a cross-functional team that includes product managers, analysts, engineers, clinical experts, and implementation partners, you will help define methodology, review measure specifications, validate source data and attribution logic, and ensure alignment between regulatory intent, analytic design, and product implementation.
• You will be expected to provide guidance on ambulatory and cross-continuum use cases, support beta implementations, evaluate data limitations and edge cases, and contribute to clear, defensible documentation that supports both internal teams and external clients.
• Success in this role requires strong healthcare (especially Provider) domain knowledge, analytical precision, and the ability to translate business and clinical requirements into scalable analytic logic.

• Undergraduate Degree in business management, information systems, or healthcare-related field or 5 years' work experience in IT or Healthcare industry.
• 3 years of demonstrated experience as a Business Analyst in support of software development.
• 3 years healthcare claims data content experience. Must be familiar with claim structure data components and relationships.

• Methodology & Healthcare Analytics Expertise (Must have)
• Demonstrated experience in healthcare analytics methodology, including measure definition, attribution logic, exclusions, denominators, and numerators, with the ability to clearly articulate “why” behind methodology decisions.
• Deep expertise in CMS quality programs, including ASCQR, OQR, and HQR (Web-based measures), with the ability to interpret regulatory updates and translate program intent into product methodology and implementation guidance.
• Proven ability to review, validate, and sign off on analytic methodology by comparing documented logic against implemented code, ensuring alignment across specification, help site documentation, and system output.
• Strong understanding of clinical, billing, and patient safety data domains, including claims and encounter level data dependencies used in Crimson AI analytics.
• Strong understanding of industry concepts, including cost of care, quality of care, utilization, value-based care, and health risk, with the ability to apply these concepts in the design and interpretation of performance and outcomes measures.
• Hands-on experience creating and maintaining formal methodology documentation, including:
  Concept Specifications Map/Dictionary Specifications Versioned methodology updates aligned to governance expectations.
• Demonstrated capability to identify, document, and explain methodology differences, with a strong focus on client trust and defensibility.
• Experience supporting client-specific investigations, including reconciling data discrepancies, validating outputs, and partnering with teams to close gaps before release.
• Experience working with CMS aligned measures, regulatory analytics, or hospital quality programs, especially in environments requiring frequent methodology updates and traceability.
• Ability to work hands-on with SQL or analytic queries to validate methodology outputs and confirm parity between code and documented logic, even when automation is not available.
• Ability to work, query in Azure Databricks, and generate analysis on client files to determine feasibility and quality of the data, identify any deficiencies.
• Working Knowledge about the HL7 - FHIR format, structure, and understanding of related data in JSON/XML format.
• Familiarity with the most used FHIR resources. Mapping of custom data models to FHIR resources…