Healthcare Project Manager

2 days ago

Mangalore, Karnataka, India beBeeHealthcare Full time ₹ 16,94,400 - ₹ 20,95,200
Job Title:

Senior Business Analyst with Healthcare Expertise

">About the Role:

This senior position requires a seasoned business analyst to lead and manage various healthcare projects. The ideal candidate will have extensive experience in analyzing and documenting complex business requirements related to HIPAA, CMS, NCQA, and state-specific regulations.

">Key Responsibilities:
  • Gather and analyze business requirements for healthcare projects.
  • Ensure system changes, processes, and documentation remain compliant with healthcare regulations and payer guidelines.
  • Collaborate with compliance and legal teams during audits or regulatory updates.
  • 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).
  • Collaborate with product and IT teams to ensure accurate coding, claims adjudication, and eligibility processing.
  • Develop and validate member-facing collateral such as Explanation of Benefits (EOBs), Summary of Benefits and Coverage (SBCs), provider directories, and plan brochures.
">Requirements:
  • Strong analytical and problem-solving skills.
  • Excellent communication and collaboration skills.
  • In-depth knowledge of healthcare regulations and payer guidelines.
  • Experience with benefit code analysis and configuration.
  • Familiarity with healthcare systems such as Facets and QNXT.
  • Ability to work effectively in a team environment.
">Benefits:

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

">Other Information:

Please note that this job description is subject to change based on the company's needs.

"],

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