Healthcare Business Development Manager

3 days ago

Surat, Gujarat, India beBeeBusiness Full time ₹ 80,00,000 - ₹ 1,20,00,000

Job Title: Senior Business Analyst with HealthCare

At our company, we are looking for a seasoned Senior Business Analyst to join our healthcare domain team. This is an excellent opportunity for a motivated professional to apply their analytical skills and knowledge of healthcare regulations to drive business growth and improvement.

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:

  • 5+ years of experience in business analysis within the healthcare industry.
  • Strong knowledge of HIPAA, CMS, NCQA, and state-specific regulations.
  • Excellent analytical and problem-solving skills.
  • Ability to communicate complex technical information to both technical and non-technical stakeholders.
  • Experience with healthcare systems and platforms (e.g., Facets, QNXT).

Benefits:

  • Competitive salary and bonus structure.
  • Comprehensive health insurance package.
  • Retirement savings plan with company match.
  • Generous paid time off and holidays.

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