Business Analyst- US Healthcare Domain

1 day ago

Bengaluru, Karnataka, India People Prime Worldwide Full time
About the job

About Client:

Our Client is a global IT services company headquartered in Southborough, Massachusetts, USA. Founded in 1996, with a revenue of $1.8B, with 35,000+ associates worldwide, specializes in digital engineering, and IT services company helping clients modernize their technology infrastructure, adopt cloud and AI solutions, and accelerate innovation. It partners with major firms in banking, healthcare, telecom, and media.

Our Client is known for combining deep industry expertise with agile development practices, enabling scalable and cost-effective digital transformation. The company operates in over 50 locations across more than 25 countries, has delivery centers in Asia, Europe, and North America and is backed by Baring Private Equity Asia.

Job Title : Business Analyst US Healthcare Domain

Key Skills : Business, HL7, FHIR, X12, BRDs, FRDs, Use Cases, Traceability Matrices.

Experience : 6-8 Years

Location: PAN INDIA

Education Qualification : Any Graduation

Work Mode : Hybrid

Employment Type : Contract to Hire

Notice Period : Immediate - 10 Days.

Job Description :

Key Responsibilities:

Strategic Analysis & Solutioning:

- Lead end-to-end business analysis for large-scale healthcare IT projects.
- Partner with business leaders to identify opportunities for digital transformation and operational efficiency.
- Define and document high-level business requirements, functional specifications, and solution architecture inputs.
- Conduct feasibility studies, gap analysis, and impact assessments for new initiatives.

Domain Expertise – US Healthcare:

- Deep understanding of Claims lifecycle: submission, adjudication, payment, and denial management.
- Expertise in Provider workflows: credentialing, contracting, network management, and data governance.
- Strong knowledge of Care Management: utilization review, case management, disease management, and appeals.
- Familiarity with Medicare/Medicaid regulations, HIPAA compliance, and value-based care models.

Technical Collaboration:

- Collaborate with product owners, architects, and developers to translate business needs into scalable solutions.
- Drive API integration strategies, data mapping, and ETL workflows for healthcare data.
- Ensure adherence to healthcare interoperability standards like HL7, FHIR, X12, and 508 Accessibility.
- Contribute to UI/UX design discussions and ensure alignment with workflow requirements.

Required Skills & Experience:

Core Business Analysis:

- Advanced proficiency in requirements elicitation, stakeholder management, and business case development.
- Strong documentation skills: BRDs, FRDs, Use Cases, Traceability Matrices.
- Experience in workflow modeling, process reengineering, and change management.

Healthcare Technology:

- Hands-on experience with healthcare SaaS platforms, multi-tenant systems, and clinical data models.
- Strong understanding of claims adjudication engines, provider data platforms, and care coordination tools.
- Experience with data extracts, reporting tools, and analytics dashboards.

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