Job Overview
This role involves acting as a strategic bridge between business stakeholders, clinical users, engineering teams, and data science teams in the healthcare domain. The focus is on designing and delivering AI Agent-based solutions, such as intelligent virtual agents, clinical decision support, care coordination assistants, patient engagement bots, automation for claims and revenue cycle management, and operational optimization.
Responsibilities
- Engage with healthcare stakeholders (providers, payers, life sciences, operations, compliance, IT) to understand business needs, workflows, and pain points.
- Analyze as-is and to-be healthcare workflows, including clinical, administrative, operational, and financial processes.
- Identify opportunities where AI Agentic systems can improve outcomes, reduce costs, or enhance efficiency.
- Define business, functional, and non-functional requirements for AI-powered and agent-based solutions.
- Collaborate with AI/ML, data engineering, and solution architecture teams to design autonomous or semi-autonomous AI agents, multi-agent workflows, and human-in-the-loop systems.
- Translate requirements into user stories/epics, process flows, decision logic, and agent orchestration diagrams.
- Support AI solutions across healthcare use cases such as patient engagement & virtual health assistants, clinical decision support systems, care management & population health, claims automation & prior authorization, revenue cycle management, and clinical documentation & EHR automation.
- Ensure solutions align with clinical safety, quality, and usability standards.
- Work with data teams to define data requirements, sources (EHR, HL7/FHIR, claims, IoT, labs), and quality metrics.
- Ensure AI solutions comply with healthcare regulations and standards including HIPAA, GDPR, HL7/FHIR, clinical governance, and audit requirements.
- Assist in defining explainability, auditability, and bias mitigation requirements for AI agents.
- Serve as a trusted advisor to clients and internal stakeholders, facilitating workshops, requirement sessions, and solution walkthroughs.
- Support Agile delivery by participating in sprint planning, backlog grooming, and UAT coordination.
- Assist with solution documentation, demos, and go-live support.
Qualifications
- 6+ years of experience as a Business Analyst / Solution Analyst in the Healthcare domain.
- Strong understanding of healthcare ecosystems (providers, payers, life sciences, EHR systems).
- Hands-on experience working on AI, ML, NLP, or automation-driven solutions.
- Understanding of AI Agents and Agentic workflows, LLM-based solutions (chatbots, copilots, virtual assistants), and human-in-the-loop AI systems.
- Ability to translate business needs into AI agent behaviors, prompts, and workflows.
- Familiarity with AI risks, ethics, and governance in healthcare.
- Experience with requirement modeling (BPMN, UML), user stories and acceptance criteria, API-based and data-driven architectures.
- Working knowledge of EHR systems (Epic, Cerner, etc.), HL7, FHIR standards, and cloud-based AI platforms (Azure, AWS, GCP – preferred).
- Excellent stakeholder management and communication skills.
- Ability to explain complex concepts clearly.
