Business Solution Manager

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🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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Abacus Insights

WebsiteLinkedInAll Job Openings

51 - 200 employees

⚕️ Healthcare Insurance

☁️ SaaS

Healthcare Insurance • SaaS • Data Management

Abacus Insights is a leader in health plan data solutions that empowers healthcare payers by providing usable and interoperable data. The company offers a comprehensive suite of data solutions designed to address complex government mandates and improve payer readiness. Abacus Insights' platform is capable of consolidating and normalizing diverse data sources into comprehensive patient records, ensuring data accuracy, and facilitating timely data updates. Their solutions support multiple use cases, including risk adjustment, clinical data exchange, cost management, and performance reporting. With a focus on technology and healthcare, Abacus Insights helps payers manage costs and improve member experiences through enhanced data management capabilities.

📋 Description

• Own the Requirements-to-Design Arc • Lead discovery sessions with client subject matter experts to understand the why and what behind each use case: the business context, pain points, expected outcomes, and success criteria, rather than just the surface-level data ask. • Translate each use case into a set of clear, testable requirements, with the success criteria and non-functional requirements that define what done looks like, keeping full traceability from business need to requirement. • Document the requirements unambiguously for the client and downstream teams, then translate them into a design the developers can build from: the source-to-target data flow, transformation logic, and business rules that produce the intended output. • Determine the appropriate grain and structure of a dataset given the business context, so the design answers the real question rather than an approximation of it — and trace how that grain decision ripples into every downstream report, model, or program that consumes the data. • Map the dependencies before finalizing a design: which other workstreams, reports, or client use cases touch this same data, and how a change here could break or benefit them. • Apply systems thinking as a default habit, not an exception: recognize when a design built for one client, state, or use case can become a reusable pattern, and actively design toward that reuse rather than discovering it in hindsight. • Work Hands-On With Data • Write and execute SQL to analyze and probe data, test assumptions, and prototype throughout requirements and design. Hands-on data work is core to this role, not occasional. • Be the Client-Facing Anchor • Drive requirements-gathering and clarification conversations with clients, since incomplete or poorly elicited requirements undermine everything built downstream. • Represent client intent throughout the engagement and remain an active point of contact through delivery. • Translate fluently between business and technical audiences, so both sides share the same understanding. • Collaborate Across Delivery • Be the central node connecting the client and the internal team, holding the business context and design drivers that shape the build. • Act as the client's SME for Solution Architects, Product, QA, Account Management, and Program Management, giving them clean hand-offs with the context, business rules, and logic they need to execute without rework or reinterpretation. • Hold the wider view across a multi-workstream engagement: understand how a decision made for one workstream affects the others, and flag those ripple effects before they surface as rework.

🎯 Requirements

• Bachelor's degree, or equivalent relevant experience. • 3+ years working in the US healthcare domain and with healthcare data (claims, provider, membership/eligibility, benefits, prior authorization, or PBM). • Payer experience required — direct experience working with or for a US health plan (Medicare, Medicaid, or Commercial), whether in-house or through healthcare consulting. • Working command of core payer concepts such as membership/enrollment, provider, claims, and authorizations, enough to reason about business context rather than specialize narrowly in any one area. • Able to write and execute SQL to explore, probe, and prototype against data. SQL is required; exposure to Databricks or Snowflake is desirable. This is distinct from a software or data engineering background. • Experience eliciting and authoring business requirements in complex, data-driven environments. • Confident client-facing communication; able to drive a conversation and elicit requirements clearly. • Comfort operating with ambiguity and re-prioritizing frequently across a large, multi-workstream engagement. • Demonstrated systems thinking: a track record of designing for reuse and scale across states, clients, or use cases rather than solving each case in isolation — able to trace how a single requirement or data model decision affects other parts of a larger data ecosystem, and to weigh those second-order effects when making design trade-offs.

🏖️ Benefits

• Unlimited paid time off – recharge when you need it • Work from anywhere – flexibility to fit your life • Comprehensive health coverage – multiple plan options to choose from • Equity for every employee – share in our success • Growth-focused environment – your development matters here • Home office setup allowance – one-time support to get you started • Monthly cell phone allowance – stay connected with ease