Atlas Systems · 17 hours ago
Business Analyst – Provider Credentialing (AI-Enabled Healthcare Platforms)
United States
Full-time
Remote
Senior Level, Lead/Staff
8+ years expAtlas Systems Inc. is a Software Solutions company headquartered in East Brunswick, NJ. They are seeking a highly experienced Business Analyst with deep domain expertise in Provider Credentialing to lead an engagement focused on reimagining provider credentialing using AI and automation. The role involves designing workflows, producing documentation, and ensuring the solution challenges legacy assumptions in credentialing operations.
Information ServicesInformation TechnologySoftware
Responsibilities
Conceptualizing disruptive, AI-assisted workflows
Designing high-fidelity Figma UI/UX
Translating the solution into engineering-ready user stories and documentation
Design high-fidelity Figma screens that depict: Provider credentialing workflows for Health Systems, Provider credentialing workflows for Health Plans
Reimagine traditional credentialing processes using: AI-assisted data ingestion and normalization, Intelligent task prioritization and exception handling, Reduced manual touchpoints and “zero-click” workflows where feasible
Cover core and advanced use cases: Initial credentialing and onboarding, Re-credentialing and continuous monitoring, Primary Source Verification (PSV), Delegated credentialing, Exception handling, expirations, and audit readiness
Clearly model: Human-in-the-loop vs AI-driven decisions, Confidence scoring, explainability, and review flows, Alerts, recommendations, and proactive interventions
Identify opportunities where AI can materially change: Time to credential, Cost per provider, Manual effort and rework, Audit and compliance burden
Ensure the solution: Goes beyond digitizing existing workflows, Challenges legacy assumptions in credentialing operations, Differentiates clearly from incumbent credentialing platforms
Produce engineering-ready artifacts, including: End-to-end use cases and workflow narratives, User stories with clear acceptance criteria, Functional requirements mapped to UI and AI behaviors, Edge cases, fallback scenarios, and exception handling
Clearly document: Where AI augments human decision-making, Where deterministic rules still apply, Guardrails for compliance, accuracy, and auditability
Review and interpret API documentation from primary credentialing data sources (e.g., CAQH, NPI, state boards, sanctions, exclusions)
Identify and document: Which APIs are invoked at each stage of the workflow, Event-driven vs on-demand data pulls, How AI layers consume, enrich, and reason over source data
Partner with engineering to ensure AI concepts are implementable, not theoretical
Qualification
Required
Deep, hands-on experience with Health System credentialing operations
Deep, hands-on experience with Health Plan / payer credentialing workflows
Deep, hands-on experience with Primary Source Verification (PSV)
Deep, hands-on experience with regulatory and compliance considerations
Prior involvement in credentialing platforms, provider data management, or payer/provider operational systems
Strong working knowledge of AI/ML-enabled enterprise products
Strong working knowledge of generative AI and intelligent automation concepts
Ability to identify where AI creates real operational leverage
Ability to avoid 'AI for AI's sake'
Ability to design explainable, compliant, and auditable AI-assisted workflows
Experience collaborating with data science or AI engineering teams
Proven experience designing enterprise-grade UX in Figma
Strong product thinking—able to connect business outcomes to UX and system behavior
Comfortable interpreting API specifications and mapping them to workflows
Experience working with agile engineering teams for clean handoff
8+ years as a Business Analyst / Product Analyst / Product Manager in healthcare technology
Experience spanning payers and provider organizations
Experience spanning platform or product-led healthcare solutions
Preferred
Prior exposure to AI-enabled healthcare platforms
Company
Atlas Systems
Atlas Systems provides innovative solutions designed to support business needs.
201-500 employees
H1B Sponsorship
Atlas Systems has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (3)
2024 (4)
2023 (7)
2022 (8)
2021 (5)
2020 (11)
Funding
Current Stage
Growth StageLeadership Team
David Stanton
Chief Marketing Officer
Kaarthick Subramanian
Chief Customer Officer
Recent News
2025-08-06
Company data provided by crunchbase