Trinetix is seeking an experienced Business Analyst / Data Analyst with strong expertise in US healthcare data, claims processing, and Accountable Care Organizations (ACO). The ideal candidate should have hands-on experience working with CCLF (Claim and Claim Line Feed) data, and proven ability to translate business requirements into technical deliverables while working closely with product managers, engineering teams, and clients.
This role will contribute to both product development and client implementations, ensuring data-driven insights and solutions that drive measurable value in the healthcare ecosystem.

REQUIREMENTS

• 5–7 years of experience as a Business Analyst / Data Analyst in the US healthcare domain.
• Strong understanding of US healthcare claims data (institutional, professional, pharmacy claims, eligibility, provider).
• Hands-on experience with CCLF (Claim and Claim Line Feed) data – data structures, use cases, validation, and reporting.
• Working knowledge of ACO programs (MSSP, ACO REACH, Shared Savings Programs) including attribution models, quality measures, and performance metrics.
• Familiarity with CMS interoperability standards – FHIR, HL7, USCDI.
• Understanding of risk adjustment models (HCC coding, RAF scores).
• Exposure to Medicare/Medicaid datasets beyond CCLF (MAO-004, MMR, PDE, etc.).
• Experience in requirement gathering, gap analysis, data mapping, BRD/FRD documentation, and writing user stories.
• Proven track record in product development lifecycles and client implementation projects.
• Excellent communication skills with ability to interact with product teams, engineers, and client stakeholders.

SOFT SKILLS

• Strong communication and stakeholder engagement skills.
• Ability to navigate ambiguity and translate complex business needs into clear, actionable requirements.
• Collaborative, self-motivated, and solution-oriented.

ABOUT US

Established in 2011, Trinetix is a dynamic tech service provider supporting enterprise clients around the world.
Headquartered in Nashville, Tennessee, we have a global team of over 1,000 professionals and delivery centers across Europe, the United States, and Argentina. We partner with leading global brands, delivering innovative digital solutions across Fintech, Professional Services, Logistics, Healthcare, and Agriculture.
Our operations are driven by a strong business vision, a people-first culture, and a commitment to responsible growth. We actively give back to the community through various CSR activities and adhere to international principles for sustainable development and business ethics.
To learn more about how we collect, process, and store your personal data, please review our Privacy Notice: https://www.trinetix.com/corporate-policies/privacy-notice

• Collaborate with product managers, engineering teams, and clients to define business requirements and translate them into functional specifications.
• Perform data analysis on US healthcare claims data (professional, institutional, and pharmacy claims) and CCLF data sets to support product features and client needs.
• Support design and validation of ACO-related reporting, quality metrics, and performance monitoring dashboards.
• Serve as subject matter expert (SME) on healthcare claims data, ACO models, and CMS programs in client discussions.
• Conduct gap analysis, data mapping, and requirements gathering for product features and client onboarding.
• Develop data validation, testing, and reconciliation strategies to ensure data quality and compliance.
• Create functional and technical documentation including BRDs, FRDs, user stories, acceptance criteria, and data dictionaries.
• Partner with implementation teams to ensure successful product deployment, integration, and client adoption.
• Stay updated on CMS regulations, ACO program changes, and healthcare interoperability standards.