About Us
Abacus Insights is changing the way healthcare works for you. We’re on a mission to unlock the power of data so health plans can enable the right care at the right time—making life better for millions of people. No more data silos, no more inefficiencies. Just smarter care, lower costs, and better experiences.
Backed by $100M from top VCs, we’re tackling big challenges in an industry that’s ready for change. And while GenAI is still new for many, we’ve already mastered turning complex healthcare data into clear, actionable insights. That’s our superpower—and it’s why we’re leading the way.
Abacus, innovation starts with people. We’re bold, curious, and collaborative—because the best ideas come from working together. Ready to make an impact? Join us and let's build the future, together.
About the Role
Join us in tackling the data usability challenge for payers. As a Business Analyst with expertise in Utilization Management (UM) and Care Management, you’ll serve as the bridge between business stakeholders, data modeling, and technical teams. Your work will ensure client needs are translated into actionable technical specifications that enable seamless data exchange and integration. You’ll leverage your knowledge of UM and Care Management operations, workflows, and data analysis to shape solutions that deliver measurable value for payers and support programs like Value-Based Care, Population Health, CMS Interoperability, and Quality.
Your Day to Day
- Gather and analyze business and technical requirements; perform gap and data analysis.
- Act as liaison between clients, product, and technical teams to define and document requirements.
- Create mock-ups, sample reports, and output tables to visualize workflows and expected results.
- Define user stories, test cases, and acceptance criteria for QA/UAT processes.
- Participate in Agile ceremonies and support sprint deliverables.
- Maintain solution artifacts including workflows, data mapping, technical specs, and UAT scenarios.
- Stay current on payer data trends to refine solutions and maximize client value.
What You Bring to the Team
- Deep understanding of UM and Care Management programs, including prior authorization, regulatory compliance, and data interpretation.
- 5+ years working with US healthcare data (claims, clinical, member, provider) and standards (HL7, FHIR, EDI).
- 5+ years in business requirements management; 3+ years in UAT process management.
- Proficiency in data mapping, exchange protocols (API, JSON, XML), and SQL/Python for data transformation.
- Strong communication skills and ability to collaborate across multiple departments.
- Self-starter with ability to manage workstreams independently and thrive in a fast-paced environment.
What We’d Like to See, But Not Required
- Knowledge of health insurance markets, government programs, and care delivery models.
- Familiarity with cloud platforms (AWS, Azure, Databricks) and healthcare analytics tools (Power BI, Tableau).
- Experience with EHRs, HIEs, and Agile methodologies.
Our Commitment as an Equal Opportunity Employer
As a mission-led technology company helping to drive better healthcare outcomes, Abacus Insights believes that the best innovation and value we can bring to our customers comes from diverse ideas, thoughts, experiences, and perspectives. Therefore, we dedicate resources to building diverse teams and providing equal employment opportunities to all applicants. Abacus prohibits discrimination and harassment regarding race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.
At the heart of who we are is a commitment to continuously and intentionally building an inclusive culture—one that empowers every team member across the globe to do their best work and bring their authentic selves. We carry that same commitment into our hiring process, aiming to create an interview experience where you feel comfortable and confident showcasing your strengths. If there’s anything we can do to support that—big or small—please let us know.
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