Job Summary And Responsibilities
Role: Sr. Specialist - Business Analyst
YOE: 10 to 12 Years
Location: Chennai, Bangalore, Hyderabad, Mumbai, Pune
About The Job
We are seeking a Sr. Specialist - Business Analyst with strong expertise in the Medicaid healthcare domain. This individual contributor role requires deep functional knowledge across Provider, Claims, and/or Financials modules within healthcare systems. You will lead complex requirement discovery, drive end-to-end functional analysis, and translate business needs into clear, testable specifications while ensuring alignment with Medicaid regulations and payer standards.
What You Will Do
- Lead requirement elicitation workshops with business and technical stakeholders for Medicaid programs and workflows.
- Own end-to-end functional analysis for Provider, Claims, or Financials modules, including current-state and future-state process definitions.
- Create and govern high-quality documentation: BRDs, FRDs, user stories, epics, acceptance criteria, process flows, and traceability matrices.
- Partner with Product Owners, Architects, and Engineering teams to clarify requirements, resolve ambiguities, and support solution design decisions.
- Drive backlog refinement, sprint planning support, and ensure readiness of user stories for development and testing.
- Lead UAT planning and execution support, including test scenario review, defect triage, and business sign-offs.
- Perform impact assessments for enhancements/releases, including upstream/downstream dependencies, data implications, and regulatory considerations.
- Support data validation and interoperability initiatives by collaborating on data mapping, field-level definitions, and integration touchpoints (as applicable).
- Act as a functional SME in cross-functional discussions, providing guidance without people-management responsibilities.
Who You Are (Education & Experience)
- 10-12 years of Business Analyst experience, with significant experience in the Medicaid healthcare domain.
- Strong hands-on exposure to Provider, Claims, and/or Financials modules and related Medicaid workflows.
- Proven experience working in Agile environments and collaborating with cross-functional delivery teams.
- Preferred certifications: Agile (CSM/PSM), Business Analysis (CBAP/CCBA), or Health Informatics (CAHIMS/CPHIMS).
Technical Skills
Job Requirements and Qualifications
- Requirements & documentation: BRDs, FRDs, epics, user stories, acceptance criteria, RTM, process flows (BPMN/UML preferred).
- Agile tools: JIRA, Rally, Trello; documentation collaboration: Confluence; diagramming: Visio.
- Healthcare standards & regulations: HL7, FHIR, ICD-10, SNOMED CT; regulatory frameworks including HIPAA and CMS.
- Medicaid / payer landscape: State Medicaid systems, MMIS modernization, payer interoperability initiatives.
- Additional skills aligned to senior experience (preferred): data mapping/validation, basic SQL for analysis, and API/integration requirement articulation for interoperability use cases.
Soft Skills
- Strong analytical thinking, problem-solving, and structured decision-making.
- Excellent stakeholder communication with the ability to simplify complex concepts into clear documentation.
- High attention to detail, strong ownership, and ability to manage multiple priorities in fast-paced delivery environments.
- Collaborative approach with confidence to challenge assumptions and drive clarity across teams.
