Exafluence
Website:
exafluence.com
Job details:
Job Description: Business Analyst (US Healthcare)
Location: Bangalore, Chennai, Tirupati
Experience: 4–8 years
Domain: US Healthcare Payer Domain with specific knowledge of Medicaid and Medicare programs.
Role Overview: We are looking for a Healthcare Business Analyst with strong domain knowledge in the US Payer space with specific knowledge of process and data related to Medicaid and Medicare programs.
Key Responsibilities
- Act as a domain SME for US Medicaid programs, including eligibility, claims, encounters, managed care, and reporting
- Gather and document business requirements, functional specs, and data mappings for healthcare data platforms
- Support data discovery and profiling for payer and state Medicaid & Medicare datasets
- Translate regulatory and program requirements into clear, implementable artifacts
- Participate in client discussions, clarifications, and walkthroughs
- Assist with UAT planning, test cases, and validation of healthcare data outputs
Required Skills & Experience
- 4+ years of experience as a Healthcare Business Analyst in US healthcare payer space
- Strong hands-on knowledge of Medicaid programs
- Familiarity with payer data domains:
- Member
- Provider
- Claims
- Encounters
- Ability to write clear BRDs, FRDs, and data mapping documents
- Strong communication skills and ability to work with US clients
Good to Have
- Exposure to FHIR (R4/R5) and interoperability initiatives
- Familiarity with CMS, T-MSIS, HEDIS, or state Medicaid reporting
- Experience working with payer or state Medicaid systems
- Prior experience working with US-based product or platform teams
Click on Apply to know more.