01Overview
Job Title: Senior Healthcare Business Analyst (SME Level)
Location: Hyderabad, India (Hybrid 3 Days/Week Work from Office)
Employment Type: Full-Time
Shift Timing: 12:00 PM 8:00 PM IST (Overlap with US Business Hours)
Experience Required :10+ Years
Domain: US Healthcare Payer / Health Plan
Lines of Business
- Medicare
- Medicaid
- Employer Group (Commercial)
- Individual & Family (ACA)
We re hiring for one of the top IT services companies.
SPADTEK Solutions is proud to collaborate with leading IT organizations to source exceptional talent for their full-time and Contract positions. Client/Implementation Partner is a globally recognized IT services and consulting company, trusted by Fortune 500 clients and enterprises worldwide. With a strong presence across cloud, data engineering, AI, and digital transformation and is known for delivering cutting-edge solutions that drive business growth and innovation. Working on enterprise-scale projects with global clients. Exposure to next-gen technologies across cloud, data, and digital platforms. A culture that values continuous learning, collaboration, and career growth. Being part of a company consistently ranked among the top IT employers. If you are an experienced professional seeking a long-term career opportunity with one of the industry s most respected names, this is your chance to join top IT services company through SPADTEK Solutions.
Job Summary
We are seeking a highly experienced Senior Healthcare Business Analyst (SME Level) to lead business and technology initiatives for a US Healthcare Payer organization. The ideal candidate will possess deep expertise in Health Plan operations across Medicare, Medicaid, Employer Group, and Individual & Family lines of business.
This role serves as a key liaison between business stakeholders, PMO, IT teams, and vendors to gather requirements, drive analysis, support testing activities, and ensure successful project delivery. The candidate should demonstrate robust communication, stakeholder management, analytical thinking, and leadership capabilities while mentoring junior analysts and driving best practices across projects.
Key Responsibilities
Business Analysis & Requirements Management
- Collaborate with business stakeholders, PMO, IT teams, and vendors to gather, analyze, and document business and functional requirements.
- Translate business needs into clear, actionable requirements and user stories.
- Develop business requirement documents (BRDs), functional specifications, use cases, process flows, and impact assessments.
- Conduct gap analysis and recommend process improvements and business solutions.
Stakeholder & Project Coordination
- Facilitate workshops, meetings, requirement gathering sessions, and stakeholder discussions.
- Present project updates, findings, recommendations, and risks to leadership and project teams.
- Coordinate with cross-functional teams to manage dependencies and ensure alignment throughout the project lifecycle.
- Maintain requirement traceability and project documentation.
Healthcare Domain Expertise
- Support initiatives across:
- Medicare Advantage, Part D, and Dual Eligible (D-SNP) programs
- Medicaid Managed Care programs
- Commercial/Employer Group plans
- Individual & Family (ACA Marketplace) plans
- Analyze healthcare business processes related to enrollment, eligibility, claims, benefits, provider management, and member services.
Testing & Quality Assurance
- Define and review test scenarios, test cases, and acceptance criteria.
- Support User Acceptance Testing (UAT) activities.
- Track defects, coordinate issue resolution, and validate successful implementation.
- Ensure delivered solutions meet business requirements and quality standards.
Leadership & Mentoring
- Mentor junior Business Analysts and provide guidance on documentation standards and best practices.
- Act as a subject matter expert (SME) for healthcare payer business processes.
- Drive continuous improvement initiatives within the Business Analysis function.
Required Skills & Qualifications
Education
- Bachelors Degree in Business Administration, Healthcare Administration, Computer Science, Information Systems, Finance, or a related field.
Experience
- 10+ years of Business Analysis experience.
- Strong experience in US Healthcare Payer/Health Plan domain.
- Experience working across one or more lines of business:
- Medicare
- Medicaid
- Commercial/Employer Group
- ACA/Individual Plans
Functional Skills
- Expertise in requirements gathering, analysis, and documentation.
- Strong understanding of healthcare payer operations and business processes.
- Experience creating:
- BRDs
- FRDs
- User Stories
- Use Cases
- Process Flow Diagrams
- Test Cases
- Traceability Matrices
Technical Skills
- Proficiency with:
- JIRA
- Confluence
- Azure DevOps
- Microsoft Visio
- Microsoft Excel
- Microsoft PowerPoint
- Strong knowledge of Agile and Waterfall methodologies.
Soft Skills .
