Senior Healthcare Business Consultant

7 days ago

Bhavnagar, Gujarat, India beBeeHealthcareDomain Full time ₹ 17,27,360 - ₹ 24,32,200
Healthcare Domain Business Analyst

Gather, analyze, and document business requirements related to regulations, standards, and guidelines in the healthcare domain.

  • Compliance: Ensure system changes, processes, and documentation remain compliant with healthcare regulations, including HIPAA, CMS, NCQA, and state-specific regulations.
  • System Configuration: Analyze and configure benefit codes for medical, dental, pharmacy, and specialty products, and support plan design, benefit mapping, and validation in healthcare systems.
  • Liaison Role: Act as liaison with compliance and legal teams during audits or regulatory updates, and collaborate with product and IT teams to ensure accurate coding, claims adjudication, and eligibility processing.
  • Content Development: 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, and partner with marketing and compliance teams to ensure content accuracy, regulatory alignment, and timely delivery.
Required Skills and Qualifications:
  • Regulatory Knowledge: In-depth knowledge of healthcare regulations, standards, and guidelines.
  • Analytical Skills: Strong analytical skills to gather, analyze, and document business requirements.
  • Communication Skills: Excellent communication and interpersonal skills to collaborate with cross-functional teams.
  • Technical Skills: Proficiency in relevant software applications and technology.
Benefits:
  • Opportunity for Professional Growth: Opportunity to work on challenging projects and develop new skills.
  • Collaborative Environment: Collaborative environment with opportunities to work with diverse teams.
  • Recognition and Rewards: Recognition and rewards for outstanding performance and contributions.

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