Principal Consultant Business Analyst Health Care !

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