Business Analyst – Provider Credentialing (AI-Enabled Healthcare Platforms)

About Us:

Atlas Systems Inc. is a Software Solutions company headquartered in East Brunswick, NJ. Incorporated in 2003, Atlas provides comprehensive range of solutions in the area of GRC, Technology, Procurement, Healthcare Provider and Oracle to customers across the globe. Combining our unparalleled experience of over a decade in the software industry and global reach, we have grown with extensive capabilities across industry verticals.

For more information, please visit our website https://www.atlassystems.com/

Please click on the link below to apply for this position

https://atlas.bamboohr.com/careers/508

Job Title

Contract Business Analyst – Provider Credentialing (AI-Enabled Healthcare Platforms)

Engagement Type

Contract / Short-Term (Immediate Start)
Location: Remote
Duration: 8–12 weeks (estimated, based on scope)
Start: Immediate

Overview

We are seeking a highly experienced Business Analyst with deep domain expertise in Provider Credentialing and strong working knowledge of AI-enabled product design to lead a defined, outcome-driven engagement.

The objective of this role is not to design “another credentialing system,” but to reimagine provider credentialing using AI, automation, and intelligent workflows—while remaining grounded in real-world payer and provider operations.

This role owns the functional vision end-to-end:

Conceptualizing disruptive, AI-assisted workflows

Designing high-fidelity Figma UI/UX

Translating the solution into engineering-ready user stories and documentation

Key Deliverables

1. AI-Forward UX & Workflow Design

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

2. Disruptive Use Case Definition

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

3. Functional & Business Documentation

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

4. API, Data & Intelligence Flow Interpretation

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.

Required Experience & Skills

Provider Credentialing Domain Expertise (Must-Have)

Deep, hands-on experience with:

Health System credentialing operations

Health Plan / payer credentialing workflows

Primary Source Verification (PSV)

Regulatory and compliance considerations

Prior involvement in credentialing platforms, provider data management, or payer/provider operational systems.

AI & Intelligent Systems Acumen (Must-Have)

Strong working knowledge of:

AI/ML-enabled enterprise products

Generative AI and intelligent automation concepts

Ability to:

Identify where AI creates real operational leverage

Avoid “AI for AI’s sake”

Design explainable, compliant, and auditable AI-assisted workflows

Experience collaborating with data science or AI engineering teams is a strong plus.

UX, Product & Technical Skills

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

Ideal Background

8+ years as a Business Analyst / Product Analyst / Product Manager in healthcare technology

Experience spanning:

Payers and provider organizations

Platform or product-led healthcare solutions

Prior exposure to AI-enabled healthcare platforms preferred

Engagement Expectations

Operate independently with minimal oversight

Drive clarity in ambiguous problem spaces

Balance innovation with regulatory realism

Deliver production-quality, future-ready artifacts

Why This Role

Opportunity to reshape how provider credentialing is done, not just improve it

High-impact engagement with clear ownership

Direct influence on a next-generation, AI-enabled healthcare platform