Business Solution Manager

Roles and Responsibilities:\n- Own the Requirements-to-Design Arc. Lead discovery sessions with client subject matter experts to understand the why and what behind each use case: the business context, pain points, expected outcomes, and success criteria, rather than just the surface-level data ask.\n- Translate each use case into a set of clear, testable requirements, with the success criteria and non-functional requirements that define what done looks like, keeping full traceability from business need to requirement.\n- Document the requirements unambiguously for the client and downstream teams, then translate them into a design the developers can build from: the source-to-target data flow, transformation logic, and business rules that produce the intended output.\n- Determine the appropriate grain and structure of a dataset given the business context, so the design answers the real question rather than an approximation of it — and trace how that grain decision ripples into every downstream report, model, or program that consumes the data.\n- Map the dependencies before finalizing a design: which other workstreams, reports, or client use cases touch this same data, and how a change here could break or benefit them.\n- Apply systems thinking as a default habit, not an exception: recognize when a design built for one client, state, or use case can become a reusable pattern, and actively design toward that reuse rather than discovering it in hindsight.\n\n### Work Hands-On With Data\n- Write and execute SQL to analyze and probe data, test assumptions, and prototype throughout requirements and design. Hands-on data work is core to this role, not occasional.\n\n### Be the Client-Facing Anchor\n- Drive requirements-gathering and clarification conversations with clients, since incomplete or poorly elicited requirements undermine everything built downstream.\n- Represent client intent throughout the engagement and remain an active point of contact through delivery.\n- Translate fluently between business and technical audiences, so both sides share the same understanding.\n\n### Collaborate Across Delivery\n- Be the central node connecting the client and the internal team, holding the business context and design drivers that shape the build.\n- Act as the client's SME for Solution Architects, Product, QA, Account Management, and Program Management, giving them clean hand-offs with the context, business rules, and logic they need to execute without rework or reinterpretation.\n- Hold the wider view across a multi-workstream engagement: understand how a decision made for one workstream affects the others, and flag those ripple effects before they surface as rework.\n\n### What you bring to the team\n- Bachelor's degree, or equivalent relevant experience.\n- 3+ years working in the US healthcare domain and with healthcare data (claims, provider, membership/eligibility, benefits, prior authorization, or PBM).\n- Payer experience required — direct experience working with or for a US health plan (Medicare, Medicaid, or Commercial), whether in-house or through healthcare consulting.\n- Working command of core payer concepts such as membership/enrollment, provider, claims, and authorizations, enough to reason about business context rather than specialize narrowly in any one area.\n- Able to write and execute SQL to explore, probe, and prototype against data. SQL is required; exposure to Databricks or Snowflake is desirable. This is distinct from a software or data engineering background.\n- Experience eliciting and authoring business requirements in complex, data-driven environments.\n- Confident client-facing communication; able to drive a conversation and elicit requirements clearly.\n- Comfort operating with ambiguity and re-prioritizing frequently across a large, multi-workstream engagement.\n- Demonstrated systems thinking: a track record of designing for reuse and scale across states, clients, or use cases rather than solving each case in isolation — able to trace how a single requirement or data model decision affects other parts of a larger data ecosystem, and to weigh those second-order effects when making design trade-offs.\n\n### What we would like to see, but not required\n- Background that already blends business analysis with hands-on data work, such as a Business Analyst or Business Data Analyst role.\n- Familiarity with HEDIS and Stars quality reporting, risk adjustment, payment integrity, value-based care analytics, provider data management, or CMS interoperability (CMS-0057).\n- Working knowledge of data modeling concepts, including how the grain and structure of a dataset shape its downstream use.\n- Familiarity with Medicaid data or PBM platforms.\n\n### Compensation: \u00A0Compensation for this role is based on experience, skills, and location, and includes base salary plus eligibility for performance bonuses and equity grants.\n\n### What you’ll get in return\n- Unlimited paid time off 2

0 recharge when you need it\n- Work from anywhere 2 0 lexibility to fit your life\n- Comprehensive health coverage 2 0 unctional plan options to choose from\n- Equity for every employee 2 0  share in our success\n- Growth-focused environment 2 0 o your development matters here\n- Home office setup allowance 2 0 f one-time support to get you started\n- Monthly cell phone allowance 2 0 stay connected with ease #LI-SB1 #LI-Remote