Senior Business Regulatory Expert

2 days ago

Allahabad, Uttar Pradesh, India beBeeRegulatory Full time ₹ 8,00,000 - ₹ 12,00,000
Job Title

Senior Business Analyst with HealthCare


About the Job

We are seeking a highly skilled Senior Business Analyst to join our team. As a key member of our organization, you will be responsible for gathering, analyzing, and documenting business requirements related to HIPAA, CMS, NCQA, and state-specific regulations.

You will ensure that system changes, processes, and documentation remain compliant with healthcare regulations and payer guidelines. This includes collaborating with compliance and legal teams during audits or regulatory updates.

Your expertise in benefit codes and plan configuration will also be crucial in analyzing and configuring benefit codes for medical, dental, pharmacy, and specialty products.

In addition, you will support plan design, benefit mapping, and validation in healthcare systems such as Facets, QNXT, or other payer platforms.

As a liaison between product and IT teams, you will ensure accurate coding, claims adjudication, and eligibility processing.

Furthermore, 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.

This role requires strong collaboration with marketing and compliance teams to ensure content accuracy, regulatory alignment, and timely delivery.

Lastly, you will track versioning and approvals of collateral to maintain consistency across all distribution channels.


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.
  • Analyze and configure benefit codes for medical, dental, pharmacy, and specialty products.
  • Support plan design, benefit mapping, and validation in healthcare systems.
  • Liaise with compliance and legal teams during audits or regulatory updates.
  • Collaborate with product and IT teams to ensure accurate coding, claims adjudication, and eligibility processing.
  • Coordinate development and validation of member-facing collateral.
  • Track versioning and approvals of collateral to maintain consistency across all distribution channels.

Requirements
  • Bachelor's degree in Business Administration, Healthcare Management, or related field.
  • Minimum 5 years of experience in healthcare business analysis.
  • Strong knowledge of HIPAA, CMS, NCQA, and state-specific regulations.
  • Experience with benefit code configuration and plan design.
  • Excellent analytical, communication, and project management skills.
  • Ability to work effectively in a fast-paced environment.

Benefits

We offer a competitive salary and benefits package, including:

  • Health insurance.
  • Dental insurance.
  • Vision insurance.
  • 401(k) matching.
  • Flexible work hours.
  • Tuition reimbursement.

Why Work With Us?

Join our dynamic team and take advantage of opportunities for growth and professional development.

We value diversity, equity, and inclusion and are committed to creating a workplace culture that is welcoming and inclusive for all employees.

Our company is dedicated to making a positive impact on the community through charitable giving and volunteer efforts.

  • Regulatory Compliance Expert

    4 days ago

    Allahabad, Uttar Pradesh, India beBeeRegulatory Full time ₹ 12,00,000 - ₹ 20,00,000

    Job Description">We are seeking a skilled Regulatory Affairs Specialist to lead our regulatory activities and ensure compliance with relevant regulations. As a key member of our team, you will play a vital role in managing CMC (Chemistry, Manufacturing, and Controls) regulatory activities for USFDA submissions.">Key Responsibilities:">Manage CMC regulatory...

  • Executive Vice President Regulatory Affairs

    5 hours ago

    Allahabad, Uttar Pradesh, India beBeeRegulatory Full time ₹ 1,80,00,000 - ₹ 2,52,00,000

    We seek individuals who uphold the highest standards of integrity, demonstrate professionalism in every interaction, treat others with respect, and consistently align personal ambition with the collective goals of the organization.Job Title: Senior Regulatory AdvisorThe Senior Regulatory Advisor will play a key role within our organization's Financial...

  • Senior Technical Expert

    4 hours ago

    Allahabad, Uttar Pradesh, India beBeeExpertise Full time ₹ 1,50,00,000 - ₹ 2,00,00,000

    Job Role: Senior SpecialistAbout the RoleWe are looking for a seasoned expert to join our team. As a Senior Specialist, you will play a pivotal role in delivering exceptional technical and functional proficiency.Your primary responsibility will be to leverage your extensive experience and knowledge of Enovia systems framework to drive business growth.You...

  • US Business Registration Expert

    5 hours ago

    Allahabad, Uttar Pradesh, India beBeeCompliance Full time US$ 1,00,000 - US$ 1,22,000

    Business Compliance Specialist - USAWe are seeking a highly skilled Business Compliance Specialist to assist companies with their business formation and registration processes in the USA. This role involves handling federal registrations, state and local tax registrations, payroll setups, and managing ongoing regulatory compliance.This position requires...

  • Senior Blockchain Expert

    21 hours ago

    Allahabad, Uttar Pradesh, India beBeeBlockchain Full time ₹ 1,50,00,000 - ₹ 2,00,00,000

    Senior Blockchain ExpertWe are seeking a seasoned senior blockchain expert to spearhead the design, development and implementation of cutting-edge blockchain solutions.Design and deploy innovative blockchain solutions including smart contracts, decentralized applications and tokenization systems.Develop secure and efficient smart contracts in Solidity/Rust...

  • Business Valuation Expert

    4 hours ago

    Allahabad, Uttar Pradesh, India beBeeBusinessValuation Full time ₹ 1,50,00,000 - ₹ 2,50,00,000

    Business Valuation ProfessionalAbout Our FirmWe are a leading professional services firm specializing in business consulting, digital transformation, taxation and accounting services. Our primary objective is to empower American businesses by providing expert guidance and support.We serve direct clients and collaborate with over 4000 CPA firms across the US....

  • Corporate Regulatory Compliance Expert

    18 hours ago

    Allahabad, Uttar Pradesh, India beBeeCompliance Full time ₹ 8,00,000 - ₹ 10,00,000

    Regulatory Compliance SpecialistThis role offers a unique opportunity to be the cornerstone of legal integrity and precision. Your primary responsibility will be ensuring that all compliance requirements are meticulously upheld, while maintaining high standards of accuracy and adherence to regulations.You will work closely with internal stakeholders to...

  • Senior Business Risk Manager

    19 hours ago

    Allahabad, Uttar Pradesh, India beBeeInternalAuditor Full time ₹ 15,00,000 - ₹ 20,00,000

    Job Description:We are currently seeking an experienced Senior Internal Auditor to lead risk-based internal audits across operational, financial, and compliance areas.The ideal candidate will have a proven track record of delivering high-quality audit engagements, with excellent communication and leadership skills. They will also be able to build strong...

  • Senior Compliance Officer

    1 hour ago

    Allahabad, Uttar Pradesh, India beBeeOperations Full time ₹ 8,00,000 - ₹ 15,00,000

    Job OverviewThe Operations Manager role is pivotal in leading and guiding a team to deliver comprehensive Anti-Money Laundering (AML) monitoring, governance, oversight, and regulatory reporting.The key objective is to design, implement, and manage a robust internal Know Your Customer (KYC) program for a multinational organization.Key ResponsibilitiesLead and...

  • Senior Partnership Development Manager

    5 hours ago

    Allahabad, Uttar Pradesh, India beBeeFinancial Full time ₹ 1,50,00,000 - ₹ 2,00,00,000

    Job Title: Senior Partnership Account ManagerAbout the Role:We are seeking a highly skilled and experienced Senior Partnership Account Manager to join our team. As a key member of our partnership management team, you will be responsible for driving the growth and performance of complex partnerships with financial institutions.Key Responsibilities:BUILD...