Senior Business Analyst with Healthcare Domain Expertise

5 days ago

Hubli, Karnataka, India beBeeBusiness Full time ₹ 8,00,000 - ₹ 10,00,000

Job Title: Senior Business Analyst with Healthcare Domain Expertise

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We are seeking a seasoned professional to lead our business analysis efforts in the healthcare domain. As a Senior Business Analyst with Healthcare Domain Expertise, you will play a key role in driving business growth and ensuring compliance with regulatory requirements.

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  • Gather, Analyze, and Document Regulatory Requirements: You will be responsible for gathering, analyzing, and documenting business requirements related to HIPAA, CMS, NCQA, and state-specific regulations.
  • Ensure Compliance: You will ensure that system changes, processes, and documentation remain compliant with healthcare regulations and payer guidelines.
  • Liaison with Compliance and Legal Teams: You will act as liaison with compliance and legal teams during audits or regulatory updates.
  • Benefit Codes and Plan Configuration: You will analyze and configure benefit codes for medical, dental, pharmacy, and specialty products.
  • Support Plan Design and Benefit Mapping: You will support plan design, benefit mapping, and validation in healthcare systems (e.g., Facets, QNXT, or other payer platforms).
  • Collaborate with Product and IT Teams: You will collaborate with product and IT teams to ensure accurate coding, claims adjudication, and eligibility processing.
  • Collateral and Member Materials: You will 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: You will partner with marketing and compliance teams to ensure content accuracy, regulatory alignment, and timely delivery.
  • Track Versioning and Approvals: You will track versioning and approvals of collateral to maintain consistency across all distribution channels.
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Required Skills and Qualifications:

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  • Bachelor's Degree: A bachelor's degree in a relevant field such as business administration, health administration, or a related field.
  • Regulatory Knowledge: In-depth knowledge of healthcare regulations, including HIPAA, CMS, NCQA, and state-specific regulations.
  • Analytical and Problem-Solving Skills: Strong analytical and problem-solving skills with the ability to gather, analyze, and document complex data.
  • Communication and Collaboration Skills: Excellent communication and collaboration skills with the ability to work effectively with cross-functional teams.
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Benefits:

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  • Competitive Salary: A competitive salary and benefits package.
  • Opportunities for Professional Growth: Opportunities for professional growth and development.
  • Diverse and Inclusive Work Environment: A diverse and inclusive work environment.
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Others:

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Please note that we are an equal opportunity employer and welcome applications from diverse candidates.

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