Manager

Virtusa; Bengaluru; On-site; INR 3,000,000 - 5,000,000; Full time

Job summary

Virtusa is seeking a senior Lead Consultant/Business Architect/Program Manager with 12-15+ years of experience in Healthcare Payer. The role focuses on gathering requirements, mapping HIPAA X12, and overseeing end-to-end consulting programs.

You will coordinate with product, ops, compliance, and providers, driving design walkthroughs and ensuring seamless integration across enrolment, claims, and payment systems.

Qualifications

• 12-15+ years in lead consulting or product/program roles in healthcare payer domain.
• Excellent communication and stakeholder management.
• Experience in creating business solutions and consulting presales.
• Experience in executing consulting assessment programs.
• Ability to gather, analyze, and document business and technical requirements.
• Experience with enrolment, claims, and payment systems (e.g., Facets, QNXT, NASCO).
• Knowledge of CMS rating standards (STAR) and quality measures reporting.
• Ability to map HIPAA X12 EDI transactions to data models and ITX transformations.
• Ability to conduct gap/impact analysis and lead design reviews.
• Coordinate across product, operations, compliance, and providers to meet integration requirements.

Responsibilities

• Lead client engagements in healthcare payer programs and manage stakeholder expectations.
• Develop and present business solutions and consulting assessment outputs.
• Coordinate cross-functional teams to ensure alignment on requirements and design.

Skills

Communication

Stakeholder management

Presales

Program management

Business solutions

Healthcare payer

Requirements gathering

Enrollment systems

Claims systems

HIPAA X12

EDI mapping

Gap analysis

Cross-functional coordination

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.