Business Analyst​/Project Manager

We are seeking an experienced
Domain Consultant
with deep expertise in the
Pre-Authorization (Pre-Auth) space within Life Sciences and Healthcare
. The ideal candidate will bring a strong understanding of payer, provider, and life sciences ecosystems, including regulatory frameworks, utilization management, patient access, and digital transformation trends. This role will combine domain knowledge, client advisory, and solution design to drive strategic engagements for pharmaceutical, biotech, and med-tech clients.

• Act as a
  subject matter expert (SME)in pre-authorization workflows, covering medical necessity, clinical documentation, prior authorization rules, and payer–provider interactions.
• Support clients in
  transforming pre-auth processes
  to improve speed, compliance, and patient experience.
• Analyze existing business processes, identify gaps, and design
  target operating models
  for pre-auth.
• Partner with technology teams to shape
  digital and GenAI solutions
  (e.g., automated prior authorization, real-time benefit checks, interoperability with EMR/EHR).
• Advise on
  compliance with CMS, FDA, and global regulations
  around pre-authorization, patient safety, and access.
• Collaborate with product managers, architects, and delivery teams to ensure
  business requirements are translated into solution designs
  .
• Conduct
  workshops with client stakeholders
  to gather business requirements, define KPIs, and build consensus.
• Contribute to
  thought leadership
  (white papers, PoVs, webinars) on pre-auth trends and innovation in life sciences.

• 7–12 years of domain experience in Life Sciences, Healthcare, or Payer/Provider organizations, with at least3–5 years focused on pre-authorization or utilization management
  .
• Strong knowledge of:
  • Prior authorization workflows (medical and pharmacy benefits)
  • Interoperability standards (HL7 FHIR, X12, NCPDP)
  • Clinical guidelines and evidence-based medical policy
  • Patient access and affordability challenges
• Exposure to
  payer and provider systems
  (EHR, claim processing, benefit management).
• Experience in
  consulting or business analysis
  roles, preferably with global clients.
• Proven ability to
  liaise between business and technology teams
  .
• Excellent communication, presentation, and stakeholder management skills.

• Experience with
  CMS interoperability mandates
  (e.g., CMS-0057-F, PA APIs).
• Knowledge of
  life sciences value chain
  (pharma/biotech market access, hub services, patient support programs).
• Familiarity with
  AI/ML and automation use cases
  in pre-auth and utilization management.
• Prior experience in a
  consulting firm or digital transformation environment
  .
• Bachelor’s or Master’s degree in
  Life Sciences, Healthcare Management, Pharmacy, or related field
  ; MBA preferred.

ETHEREUM TECHNOLOGIES LLC is an equal opportunity employer inclusive of female, minority, disability and veterans, (M/F/D/V). Hiring, promotion, transfer, compensation, benefits, discipline, termination and all other employment decisions are made without regard to race, color, religion, sex, sexual orientation, gender identity, age, disability, national origin, citizenship/immigration status, veteran status or any other protected status. ETHEREUM TECHNOLOGIES LLC will not make any posting or employment decision that does not comply with applicable laws relating to labor and employment, equal opportunity, employment eligibility requirements or related matters.

Nor will ETHEREUM TECHNOLOGIES LLC require in a posting or otherwise U.S. citizenship or lawful permanent residency in the U.S. as a condition of employment except as necessary to comply with law, regulation, executive order, or federal, state, or local government contract