Abacus Insights - Business Solution Manager

• 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. • 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. • 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. • 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. • 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. • Work Hands-On With Data • 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. • Be the Client-Facing Anchor • Drive requirements-gathering and clarification conversations with clients, since incomplete or poorly elicited requirements undermine everything built downstream. • Represent client intent throughout the engagement and remain an active point of contact through delivery. • Translate fluently between business and technical audiences, so both sides share the same understanding. • Collaborate Across Delivery • Be the central node connecting the client and the internal team, holding the business context and design drivers that shape the build. • 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. • 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. • Bachelor's degree, or equivalent relevant experience. • 3+ years working in the US healthcare domain and with healthcare data (claims, provider, membership/eligibility, benefits, prior authorization, or PBM). • Payer experience required — direct experience working with or for a US health plan (Medicare, Medicaid, or Commercial), whether in-house or through healthcare consulting. • 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. • 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. • Experience eliciting and authoring business requirements in complex, data-driven environments. • Confident client-facing communication; able to drive a conversation and elicit requirements clearly. • Comfort operating with ambiguity and re-prioritizing frequently across a large, multi-workstream engagement. • 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. • What we would like to see, but not required • Background that already blends business analysis with hands-on data work, such as a Business Analyst or Business Data Analyst role. • Familiarity with HEDIS and Stars quality reporting, risk adjustment, payment integrity, value-based care analytics, provider data management, or CMS interoperability (CMS-0057). • Working knowledge of data modeling concepts, including how the grain and structure of a dataset shape its downstream use. • Familiarity with Medicaid data or PBM platforms. • Compensation: Compensation for this role is based on experience, skills, and location, and includes base salary plus eligibility for performance bonuses and equity grants.