Consulting Director

Virtusa; Tamil Nadu; On-site; INR 1,400,000 - 2,100,000; Full time

Job summary

Virtusa seeks a senior Lead Consultant/Business Architect/Program Manager with 12-15+ years in healthcare payer consulting to guide client engagements and solution design. You will coordinate across product, operations, compliance and providers, mapping requirements to IT solutions and leading assessment programs.

Strong communication, stakeholder management, and experience with enrolment/claims systems (Facets, QNXT, NASCO) are essential. Knowledge of CMS STAR metrics would be advantageous.

Qualifications

• 12-15+ years of experience in lead consulting roles within healthcare payer domains.
• Strong communication skills and stakeholder management.
• Experience in creating business solutions and consulting presales.
• Experience executing consulting assessment programs.
• Ability to gather, analyse, and document business and technical requirements for healthcare programs.
• Familiarity with enrolment, claims, and payment systems (Facets, QNXT, NASCO).
• Knowledge of CMS rating standards (STAR) and quality measures reporting.
• Ability to map HIPAA X12 EDI transaction sets to system data models.
• Conduct gap analysis, impact analysis, and facilitate design walkthroughs.
• Coordinate across cross-functional teams (product, ops, compliance, providers) to ensure integration requirements are met.

Responsibilities

• Lead consulting engagements with healthcare payer clients.
• Drive presales and solution design activities.
• Perform gap and impact analyses across programs.
• Coordinate cross-functional teams to ensure integration with systems.

Skills

Communication

Stakeholder management

Business solutions

Presales consulting

Requirement gathering

Healthcare payer domain

Enrolment and Claims systems

HIPAA X12 mapping

EDI transactions mapping

Gap & impact analysis

Cross-functional coordination

Tools

Facets

QNXT

NASCO

Job description

• 12 -15+ years of experience as a Lead Consultant/Business Architect/Program Manager/ Product Manager with Healthcare Payer domain.
• Excellent Communication Skill and managing client stakeholders
• Experience in creating Business solutions . Worked on consulting presales activities
• Experience in executing Consulting Assessment programs
• Ability Gather, analyse, and document business and technical requirements for healthcare Programs
• Experience on core business applications in Enrolment, Claims. Payment areas (Facets, QNXT , NASCO etc )
• Knowledge of CMS rating standards (STAR) and quality measures reporting
• Ability to Interpret and map HIPAA X12 EDI transaction sets (e.g., 270/271, 837, 835, 999) to system data models and ITX transformations.
• Conduct gap analysis, impact analysis, and facilitate design walkthroughs with business and technical teams.
• Coordinate across cross-functional teams (product, ops, compliance, providers) to ensure integration requirements are met.