Business Systems Analyst for AI

As a Business Systems Analyst focused on AI, you will serve as a strategic liaison between business stakeholders and technical teams to drive the discovery, design, and implementation of AI/ML solutions. You will identify high-impact opportunities such as Prior Authorization Automation, Fraud/Waste/Abuse Detection, and Drug Recommendation systems, translating business needs into actionable AI/ML requirements. Your role will involve defining data pipelines, ensuring regulatory compliance, and supporting model governance through bias detection, explainability, and performance monitoring. You will collaborate cross-functionally to develop ROI analyses, lead user acceptance testing (UAT), and manage change initiatives to ensure successful AI adoption. Additionally, you will support the full AI/ML lifecycle, from documenting use cases to monitoring production models and optimizing human-in-the-loop workflows.

We are a company committed to creating inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity employer that believes everyone matters. Qualified candidates will receive consideration for employment opportunities without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, disability, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to Human Resources Request Form. The EEOC "Know Your Rights" Poster is available here.

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- Minimum Bachelors degree
- 6+ years of experience as a BSA, with at least 1 year in an organization using AI/ML
- Expertise of Agile/Scrum methodologies
- Solid understanding of AI/ML concepts (ex: supervised/unsupervised learning, NLP, and LLMs)
- Ability to analyze complex data flows and troubleshoot root causes
- Excellent written and verbal communication skills for translating technical concepts to non-technical audiences
- Proven ability to manage multiple projects with shifting priorities and deadlines

- Strong SQL and Python skills for data analysis and feature engineering
- Experience within PBM (pharmacy benefit management) industry
- Knowledge of HIPAA and AI ethics frameworks (e.g., NIST AI RMF)
- Experience with generative AI applications (e.g., automated prior authorization, appeal messaging)
- Familiarity with healthcare data types such as claims, EHR, pharmacy, and eligibility data

Benefit packages for this role will start on the 31st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.