Business Solution Manager

About the role

Join our team as a Business Solution Manager, where you'll bridge the gap between client business needs and design implementation. You'll be responsible for defining and ensuring the quality of business requirements, translating complex healthcare challenges into precise requirements, and making design choices that hold up across a larger system. This client-facing role requires a strong command of healthcare business context and data literacy. Key missions: Lead discovery sessions with client subject matter experts to understand the business context, pain points, expected outcomes, and success criteria.. 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.. Document the requirements unambiguously for the client and downstream teams, then translate them into a design the developers can build from. Profile: - 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 - Payer experience required — direct experience working with or for a US health plan (Medicare, Medicaid, or Commercial), whether in-house or through healthcare consulting - 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 - Experience eliciting and authoring business requirements in complex, data-driven environments - 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 - Confident client-facing communication; able to drive a conversation and elicit requirements clearly - 3+ years working in the US healthcare domain and with healthcare data (claims, provider, membership/eligibility, benefits, prior authorization, or PBM) - Comfort operating with ambiguity and re-prioritizing frequently across a large, multi-workstream engagement - Bachelor's degree, or equivalent relevant experience - Background that already blends business analysis with hands-on data work, such as a Business Analyst or Business Data Analyst role - Working knowledge of data modeling concepts, including how the grain and structure of a dataset shape its downstream use - Familiarity with HEDIS and Stars quality reporting, risk adjustment, payment integrity, value-based care analytics, provider data management, or CMS interoperability (CMS-0057) - Familiarity with Medicaid data or PBM platforms