Omega Healthcare Management Services

AI Product Business Analyst

Omega Healthcare Management Services  •  United States (Onsite)  •  2 days ago
Apply
AI can make mistakes so check important info. Chat history is never stored.

Job Description

The AI Product Business Analyst will serve as the vital link between our clinical operations teams and our AI development team. This position will be responsible for creating complex medical coding requirements from subject matter experts and translating them into actionable user stories and functional specifications for our Agentic AI engine. The goal is to ensure that the “logic” the AI learns is perfectly aligned with industry standards and specific client needs.

Essential Job Functions

  • Conduct workshops with Clinical SMEs and RCM experts to document specialty-specific coding rules and nuances.

  • Write detailed user stories, acceptance criteria, and functional requirements specifically for AI/ML features (e.g. The model must identify unbundled procedures in cardiology charts).

  • Translate high-level business goals into technical requirements that include data labeling instructions, expected model outputs, and edge-case handling.

  • Define and execute User Acceptance Testing (UAT) strategies to ensure the AI engine’s output meets the documented business requirements.

  • Manage and prioritize the product backlog, ensuring the AI development team always has a “definition of ready” for the next sprint.

  • Identify discrepancies between current manual coding workflows and the proposed AI-automated states, proposing logic-based solutions to bridge the gap.

  • Assist in mapping clinical data elements from various HER/EMR systems to the standardized inputs required by the auto-coding engine.

Key Success Indicators/Attributes

  • The ability to capture clinical nuances so clearly that developers require minimal “back-and-forth” to begin model training.

  • A data-driven approach to evaluating model performance against initial business requirements.

  • The ability to walk a clinical coder through an AI workflow and turn their feedback into a technical improvement.

  • Comfort with “if-then-else” logic structures and how they translate into machine learning decision-making.

The AI Product Business Analyst will serve as the vital link between our clinical operations teams and our AI development team. This position will be responsible for creating complex medical coding requirements from subject matter experts and translating them into actionable user stories and functional specifications for our Agentic AI engine. The goal is to ensure that the “logic” the AI learns is perfectly aligned with industry standards and specific client needs.

Essential Job Functions

  • Conduct workshops with Clinical SMEs and RCM experts to document specialty-specific coding rules and nuances.

  • Write detailed user stories, acceptance criteria, and functional requirements specifically for AI/ML features (e.g. The model must identify unbundled procedures in cardiology charts).

  • Translate high-level business goals into technical requirements that include data labeling instructions, expected model outputs, and edge-case handling.

  • Define and execute User Acceptance Testing (UAT) strategies to ensure the AI engine’s output meets the documented business requirements.

  • Manage and prioritize the product backlog, ensuring the AI development team always has a “definition of ready” for the next sprint.

  • Identify discrepancies between current manual coding workflows and the proposed AI-automated states, proposing logic-based solutions to bridge the gap.

  • Assist in mapping clinical data elements from various HER/EMR systems to the standardized inputs required by the auto-coding engine.

Key Success Indicators/Attributes

  • The ability to capture clinical nuances so clearly that developers require minimal “back-and-forth” to begin model training.

  • A data-driven approach to evaluating model performance against initial business requirements.

  • The ability to walk a clinical coder through an AI workflow and turn their feedback into a technical improvement.

  • Comfort with “if-then-else” logic structures and how they translate into machine learning decision-making.

    Required Education and Experience

  • Bachelor’s degree in business, computer science, health informatics, or a related field.

  • 5+ years as a business analyst, with at least 2 years focused on AI, machine learning, or advanced analytics products.

  • Exceptional skill in writing user stories within an Agile framework, specifically for complex logic-based systems.

  • Solid understanding of how AI models are trained and the difference between deterministic logic and probabilistic AI outputs.

  • Expert proficiency in Jira, Confluence, and wireframing/flowcharting tools (e.g. Lucidchart, Visio).

Preferred Education and Experience

  • Experience in healthcare, RCM, or medical coding is highly preferred.

  • Ability to write basic SQL queries to analyze data sets for requirement validation.

  • CSPO (Certified Scrum Product Owner) or similar BA certifications.

  • Understanding of the prompts and “instructions” needed to guide Large Language Models.

Supervisory Responsibility

No.

Work Environment

This job operates in a remote home office environment This role routinely uses standard office equipment such as computers and phones

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; and talk or hear. The employee must occasionally lift or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, peripheral vision, depth perception and the ability to adjust focus.

Position Type/Expected Hours of Work

This is a full-time position. Days and hours of work are generally Monday through Friday, 8:00 a.m. to 5 p.m. This position occasionally requires long hours and weekend work.

Travel

Minimal travel required; up to 10%

Equal Employment Opportunity:

Omega Healthcare is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, gender, age, sexual orientation, gender identity or expression, marital status, mental or physical disability, protected veteran status, and genetic information, or any other basis protected by applicable law. Omega Healthcare also prohibits harassment of applicants or employees based on any of these protected categories.

Omega Healthcare makes reasonable accommodations when needed for applicants and candidates with disabilities or religious observances. If reasonable accommodation is needed to participate in the job application, interview, or any other part of the hiring process, please contact Human Resources at employeerelationsus@omegahms.com

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. Employee may perform other duties as assigned.

Supervisory Responsibility

No.

Work Environment

This job operates in a remote home office environment This role routinely uses standard office equipment such as computers and phones

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; and talk or hear. The employee must occasionally lift or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, peripheral vision, depth perception and the ability to adjust focus.

Position Type/Expected Hours of Work

This is a full-time position. Days and hours of work are generally Monday through Friday, 8:00 a.m. to 5 p.m. This position occasionally requires long hours and weekend work.

Travel

Minimal travel required; up to 10%

Equal Employment Opportunity:

Omega Healthcare is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, gender, age, sexual orientation, gender identity or expression, marital status, mental or physical disability, protected veteran status, and genetic information, or any other basis protected by applicable law. Omega Healthcare also prohibits harassment of applicants or employees based on any of these protected categories.

Omega Healthcare makes reasonable accommodations when needed for applicants and candidates with disabilities or religious observances. If reasonable accommodation is needed to participate in the job application, interview, or any other part of the hiring process, please contact Human Resources at employeerelationsus@omegahms.com

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. Employee may perform other duties as assigned.

Founded in 2003, Omega Healthcare Management Services® (Omega Healthcare) empowers healthcare to thrive via intelligent solutions that optimize revenue cycle operations, administrative workflows, care coordination, and clinical research on a global scale. The company works with providers, payers, life science companies, medical device manufacturers, health technology firms, researchers, and industry partners to amplify teams with robust technology, specialty expertise, and operational support. Omega Healthcare serves more than 350 healthcare organizations with 35,000 skilled workers in the United States, India, Colombia, and the Philippines. For more information, visit www.omegahms.com

We offer a comprehensive benefits package that may include health, dental, and vision coverage, voluntary insurance options, a 401(k) plan with employer match, professional development opportunities, paid time off, and holiday pay. Eligible employees may also have the opportunity to participate in bonus programs, commissions, or other variable incentive plans. Benefits and incentive eligibility may vary based on position, location, and tenure.

AAP/EEO Statement

Omega Healthcare is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, gender, age, sexual orientation, gender identity or expression, marital status, mental or physical disability, protected veteran status, and genetic information, or any other basis protected by applicable law. Omega Healthcare also prohibits harassment of applicants or employees based on any of these protected categories.

Omega Healthcare makes reasonable accommodations when needed for applicants and candidates with disabilities or religious observances. If reasonable accommodation is needed to participate in the job application, interview, or any other part of the hiring process, please contact Human Resources at employeerelationsus@omegahms.com

Omega Healthcare Management Services

About Omega Healthcare Management Services

Founded in 2003, Omega Healthcare Management Services® (Omega Healthcare) empowers healthcare to thrive via intelligent solutions that optimize revenue cycle operations, administrative workflows, care coordination, and clinical research on a global scale. The company works with providers, payers, life science companies, medical device manufacturers, health technology firms, researchers, and industry partners to amplify teams with robust technology, specialty expertise, and operational support. Omega Healthcare serves 350+ healthcare organizations with 35,000 skilled workers in the United States, India, Colombia, and the Philippines. For more information, visit www.omegahms.com

End-to-End Revenue Cycle Management Solutions:

Patient Access

- Scheduling & Registration

- Insurance Eligibility & Benefits Verification

- Prior Authorization

Mid-Revenue Cycle

- Medical Records Coding

- Charge Capture

- Chart Audit

- Chart Audits

- Clinical Documentation Improvement

- HCC Coding Review

Business Office

- Claims Management & Billing

- Payment Posting & Reconciliation

- A/R Management & Collections

- Denials & Appeals Management

- Underpayment Analysis & Recovery

- Data Analytics Platform (WhiteSpace Analytics)

Full Business Office

Care Coordination

- Remote Patient Monitoring

- Telephone/Message Nurse Triage

- Customer Contact Center

Health Data Curation

- Clinical Trial Data Solutions

- Real-World Data Curation

- AI/ML Model Validation and Enablement

- Registry Data Management

Payer Operations

- Risk Adjustment Documentation & Coding Review

- HEDIS Chart Abstraction

- Care Coordination

- Provider & Member Communication

- Utilization Management

- Claims Administration

- Member Management

- Provider Data & Network Management

Pharma:

Access

- Member Enrollment

- Benefit Verification

- Prior Authorizations

Affordability

- Patient Co-pay Assistance

Adherence

- Care Coordination

Industry
Healthcare & Social Services
Company Size
10,000+ employees
Headquarters
Boca Raton, Florida
Year Founded
2003
Social Media