Business System Analyst – Digital health

CGI is seeking a Digital Health Business Systems Analyst is a strategic and hands-on implementation partner within a healthcare payer organization responsible for driving the end-to-end evaluation onboarding and operational integration of digital health vendor solutions. This role owns the business and technical requirements lifecycle for a growing portfolio of point solutions across musculoskeletal health behavioral health chronic disease management remote patient monitoring and wellness spanning vendors such as Hinge Health Omada Livongo Sword Health Calm Teladoc Brightline and others.

The BSA bridges strategy and execution: translating clinical program goals and payer operations requirements into technical specifications data exchange designs and vendor accountability frameworks. This individual will work closely with clinical network IT product compliance and vendor teams to ensure that each digital health solution is implemented on time within scope and delivers measurable member and business outcomes.

This role must be performed from the client site in Canton MA (Hybrid)

Vendor Evaluation & Solution Selection Support
.Partner with clinical product and finance teams to define requirements for new digital health point solutions including scope target population eligibility criteria and integration needs.
.Conduct demos due diligence sessions and reference checks with prospective vendors; synthesize findings into executive-ready recommendations.
.Assess vendor data security posture HIPAA compliance SOC 2 certification and interoperability capabilities (FHIR HL7 API-first vs. flat-file) as part of selection criteria.
.Maintain a living digital health vendor landscape map tracking competitive landscape emerging solutions and market-moving clinical evidence.
Implementation Planning & Execution
.Lead end-to-end implementation of digital health vendor solutions serving as the primary business and technical liaison between the health plan and vendor project teams.
.Define project scope workstreams milestone plans RACI matrices and risk registers for each vendor implementation.
.Facilitate discovery workshops with internal stakeholders (IT clinical network member services compliance) to capture current-state workflows and future-state requirements.
.Translate business and clinical requirements into detailed functional specifications data mapping documents and integration design artifacts.
.Oversee and execute UAT planning test script development defect tracking and go/no-go sign-off processes.
.Manage phased rollout strategies including pilot populations eligibility file configurations member outreach sequencing and benefit design alignment.
Data Integration & Interoperability
.Own data exchange design for all vendor integrations including eligibility feeds (834/custom) claims data sharing clinical data (FHIR R4 HL7 2.x) and outcomes reporting files.
.Partner with IT/data engineering teams to design test and validate automated eligibility enrollment and disenrollment workflows for each vendor platform.
.Ensure data governance standards are applied across integrations including PHI handling data minimization and audit logging.
.Troubleshoot and resolve data feed issues transformation errors and reconciliation discrepancies in production environments.
.Support Single Sign-On (SSO) and API integration design between the member portal mobile app and vendor platforms.
Benefits Configuration & Eligibility Operations
.Partner with benefits design and actuarial teams to translate digital health benefit structures into vendor-specific eligibility and access configurations.
.Manage eligibility cohort definitions suppression logic and override workflows across the vendor portfolio.
.Ensure alignment between vendor eligibility configurations and plan benefit package (PBP) structures for Medicare Advantage Commercial and Medicaid lines of business.
.Coordinate with member services on member-facing communication content escalation pathways and digital health program FAQs.
Clinical & Regulatory Alignment
.Ensure all digital health solutions comply with applicable regulatory requirements including CMS telehealth and remote monitoring coverage rules state licensure laws and NCQA standards.
.Collaborate with the clinical programs team to align vendor clinical protocols with evidence-based care standards and health plan utilization management policies.
.Partner with compliance on vendor oversight program requirements HIPAA risk assessments and audit documentation.
Analytics Reporting & Value Demonstration
.Design and maintain a digital health program performance dashboard tracking enrollment engagement clinical outcomes cost trends and ROI across the vendor portfolio.
.Conduct pre/post analysis and member cohort studies to quantify program value and inform benefit design decisions.
.Produce executive and board-level reporting on digital health portfolio performance and strategic roadmap progress.
.Collaborate with the data analytics team on claims-based outcome studies and vendor attribution methodologies.
.Support actuarial and finance teams with program savings estimates for annual budget and bid cycles.
Stakeholder Engagement & Change Management
.Serve as a trusted advisor and digital health subject matter expert for internal clinical network product and executive stakeholders.
.Develop and deliver training materials workflow guides and operational playbooks for new digital health program launches.
.Champion member experience considerations in all implementation decisions including app usability access friction and health equity factors.
.Support internal change management for care management and member services teams integrating digital health tools into existing workflows.

.7 years of experience in healthcare IT digital health or payer operations with at least 3 years focused on vendor implementations or digital health program management.
.Direct experience implementing digital health or care management vendor solutions at a health plan health system or consulting firm.
.Working knowledge of healthcare data standards: HL7 FHIR R4 X12 834/837/835 and REST/SOAP API integrations.
.Proficiency in business analysis disciplines: requirements elicitation process mapping functional specifications use cases and UAT management.
.Demonstrated ability to manage cross-functional projects with multiple workstreams vendors and stakeholders simultaneously.
.Strong data analysis skills with proficiency in Excel SQL or BI tools (Tableau Power BI or similar).
.Excellent written and verbal communication skills; ability to translate between technical and non-technical audiences.
.Experience with HIPAA compliance BAA requirements and healthcare data security standards.

.Bachelors degree in health informatics Health Administration Business Information Systems or a related field.

Other Information:
CGI is required by law in some jurisdictions to include a reasonable estimate of the compensation range for this role. The determination of this range includes various factors not limited to skill set level experience relevant training and licensure and certifications. To support the ability to reward for merit-based performance CGI typically does not hire individuals at or near the top of the range for their role. Compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range for this role in the U.S. is $80600.00 - $172400.00.

CGIs benefits are offered to eligible professionals on their first day of employment to include:
. Competitive compensation
. Comprehensive insurance options
. Matching contributions through the 401(k) plan and the share purchase plan
. Paid time off for vacation holidays and sick time
. Paid parental leave
. Learning opportunities and tuition assistance
. Wellness and Well-being programs

#LI-MP2

• Data Analysis
• Health Care Analytics
• Health Care Payers
• Oracle
• Problem Management
• SQL

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