Life Sciences Business Architect

6 days ago — Be among the first 25 applicants

Role: Life Sciences Business Architect / Domain Consultant

Experience: 7–12 Years

Location: Valencia, CA

Overview

We’re looking for an experienced professional with strong expertise in the Pre-Authorization (Pre-Auth) space within Life Sciences and Healthcare. The role involves advising clients, analyzing processes, and designing digital solutions to optimize pre-auth workflows and patient access.

Key Responsibilities

• Act as a Subject Matter Expert (SME) in pre-authorization workflows (medical necessity, clinical documentation, payer–provider interactions).
• Analyze current processes and design target operating models for pre-auth transformation.
• Collaborate with tech teams to design and implement digital/AI-based pre-auth solutions.
• Ensure compliance with CMS, FDA, and global regulations.
• Lead client workshops and define KPIs to improve efficiency and patient experience.

Required Skills

• 7–12 years in Life Sciences, Healthcare, or Payer/Provider domains (with 3–5 years in Pre‑Auth or Utilization Management).
• Deep understanding of prior authorization workflows, interoperability (HL7 FHIR, X12, NCPDP), and clinical guidelines.
• Hands‑on experience with EHR, claims, and benefit management systems.
• Excellent consulting, business analysis, and stakeholder management skills.

Preferred

• Knowledge of CMS interoperability mandates and Life Sciences value chain.
• Exposure to AI/automation use cases in pre‑auth.
• MBA or advanced degree in Life Sciences/Healthcare preferred.

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