Healthcare Business Strategist

24 hours ago

Ghaziabad, Uttar Pradesh, India beBeeRegulatory Full time ₹ 15,64,800 - ₹ 26,16,000
Job Title: Senior Business Analyst with HealthCare

Role Summary:

We are seeking a seasoned Senior Business Analyst to join our team in the Healthcare Domain. The ideal candidate will possess excellent analytical skills, strong business acumen, and the ability to communicate effectively with stakeholders.

Key Responsibilities:

  • Gather, analyze, and document business requirements related to HIPAA, CMS, NCQA, and state-specific regulations.
  • Ensure system changes, processes, and documentation remain compliant with healthcare regulations and payer guidelines.
  • Act as liaison with compliance and legal teams during audits or regulatory updates.
  • Benefit Codes & Plan Configuration
  • Analyze and configure benefit codes for medical, dental, pharmacy, and specialty products.
  • Support plan design, benefit mapping, and validation in healthcare systems (e.g., Facets, QNXT, or other payer platforms).
  • Collaborate with product and IT teams to ensure accurate coding, claims adjudication, and eligibility processing.
  • Collateral & Member Materials
  • Coordinate development and validation of member-facing collateral such as Explanation of Benefits (EOBs), Summary of Benefits and Coverage (SBCs), provider directories, and plan brochures.
  • Partner with marketing and compliance teams to ensure content accuracy, regulatory alignment, and timely delivery.
  • Track versioning and approvals of collateral to maintain consistency across all distribution channels.

Required Skills and Qualifications:

  • Strong understanding of healthcare regulations, including HIPAA, CMS, and NCQA.
  • Experience with benefit code configuration and plan design.
  • Excellent analytical and problem-solving skills.
  • Strong communication and interpersonal skills.
  • Ability to work effectively in a team environment.
  • Detail-oriented and organized with strong project management skills.
  • Proficient in Microsoft Office, particularly Excel, Word, and PowerPoint.

Benefits:

This role offers a competitive salary, comprehensive benefits package, and opportunities for professional growth and development.

Others:

The successful candidate will have the opportunity to work on challenging projects, collaborate with cross-functional teams, and contribute to the success of our organization.

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