Senior HealthCare Business Professional

7 days ago


Davangere, Karnataka, India beBeeCompliance Full time ₹ 9,00,000 - ₹ 12,00,000
Healthcare Business Analyst

Our company seeks a Business Analyst – Healthcare Domain with exceptional analytical and communication skills to join our team. As a key member of the business analysis team, you will be responsible for gathering, analyzing, and documenting business requirements related to HIPAA, CMS, NCQA, and state-specific regulations.

Key Responsibilities:
  • Gather and Analyze Business Requirements: Gather, analyze, and document business requirements related to HIPAA, CMS, NCQA, and state-specific regulations.
  • Ensure Regulatory Compliance: Ensure system changes, processes, and documentation remain compliant with healthcare regulations and payer guidelines.
  • Liaise with Compliance and Legal Teams: Act as liaison with compliance and legal teams during audits or regulatory updates.
  • Benefit Codes and Plan Configuration
  • Configure Benefit Codes: Analyze and configure benefit codes for medical, dental, pharmacy, and specialty products.
  • Support Plan Design: Support plan design, benefit mapping, and validation in healthcare systems (e.g., Facets, QNXT, or other payer platforms).
  • Collaborate with Product and IT Teams: Collaborate with product and IT teams to ensure accurate coding, claims adjudication, and eligibility processing.
  • Collateral and Member Materials
  • Coordinate Development of Collateral: 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: Partner with marketing and compliance teams to ensure content accuracy, regulatory alignment, and timely delivery.
  • Track Versioning and Approvals: Track versioning and approvals of collateral to maintain consistency across all distribution channels.


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