Job Description
Inviting applications for the role of Principal Consultant - Business Analyst Health Care !
In this role, you will be responsible for partnering with business stakeholders, product owners, and technology teams to analyze, validate, and translate business requirements within the Health Insurance domain. You will play a crucial role in understanding payer processes, supporting system enhancements, driving operational efficiency, and ensuring that solutions align with business objectives. This role demands strong domain expertise, analytical thinking, and the ability to communicate effectively across business and technical teams.
Responsibilities
Gather, analyze, and document business requirements for health insurance processes (Claims, Enrollment, Provider, Billing, Policy Admin, Underwriting, etc.)
Translate business needs into functional specifications, user stories, and acceptance criteria
Support product owners in backlog prioritization and grooming
Perform gap analysis, process mapping, and impact assessment for new solutions or enhancements
Work closely with development and QA teams to ensure solution alignment and readiness
Conduct endtoend UAT planning, execution, and signoff
Coordinate with crossfunctional teams to ensure seamless delivery and issue resolution
Present insights, reports, and recommendations to stakeholders and leadership teams
Support audit, compliance, and regulatory requirement interpretation within Health Insurance
Guide teams with domain expertise and contribute to solution design discussions
Minimum Qualifications
Bachelor's degree in Engineering, IT, Business, or related field
Proven experience as a Business Analyst or Functional Consultant in the Health Insurance domain
Strong understanding of payer workflows - Claims processing, Enrollment, Provider management, Benefits, Policy admin, Authorization
Experience writing BRD/FRD, user stories, process flows, and functional specifications
Hands-on experience with Agile/Scrum methodologies
Strong analytical, problemsolving, and communication skills
Preferred Qualifications
Exposure to US Health Insurance regulatory requirements (HIPAA, EDI 834/837/270/271, ICD10, CPT)
Experience working with product/platform modernization initiatives
Knowledge of healthcare analytics and reporting
Experience in working with crossfunctional, geographically distributed teams
Certification in Business Analysis (CBAP, CCBA) or Agile methodologies is a plus
Familiarity with tools like JIRA, Confluence, Visio, or equivalent BPM tools