Senior Business Analyst - Healthcare Provider

Quantiphi; Bengaluru; On-site; INR 900,000 - 1,500,000; Full time

Job summary

Quantiphi in Bengaluru seeks a Senior Business Analyst to bridge provider needs with technology solutions within HCLS. You will lead requirements gathering, process mapping, and data analysis for provider-focused projects such as EHR integration, revenue cycle management, patient engagement, and clinical workflow optimization.

You will mentor junior analysts and champion best practices, ensuring compliance with HIPAA/HITECH and value-based care models across implementations.

Qualifications

• Senior BA experience in HCLS domain with provider focus.
• Strong skills in requirements elicitation, analysis, and BPMN.
• Knowledge of HIPAA, HITECH, MIPS/MACRA, HL7/FHIR is required.

Responsibilities

• Lead workshops with clinicians, revenue cycle, IT, and compliance to elicit detailed requirements.
• Analyze current and future state processes for provider operations and clinical workflows.
• Translate needs into functional and non-functional requirements, user stories, and process maps.
• Collaborate with architects and product owners to validate technical solutions.
• Evaluate COTS vs custom development and perform gap analyses.
• Develop business cases, ROI analyses, and project roadmaps.
• Ensure regulatory compliance for HIPAA, HITECH, MIPS/MACRA, and related laws.

Skills

Process modeling

Data visualization

Tableau

Power BI

Regulatory compliance

HIPAA/HITECH/MACRA

API concepts

UAT testing

Provider operations

Stakeholder management

Leadership

Tools

Epic

Cerner/Oracle Health

Job description

As a Senior Business Analyst (Provider) in HCLS, you'll be the bridge between complex healthcare provider needs and innovative technology solutions. You'll lead requirements gathering, process mapping, and data analysis for provider-focused projects (e.g., EHR integration, revenue cycle management, patient engagement, clinical workflow optimization). Your expertise in provider operations, regulatory compliance (e.g., HIPAA, MIPS/MACRA), and value-based care models will drive the design and implementation of impactful solutions, ensuring alignment with business objectives and delivering measurable value to our clients. You'll mentor junior analysts and champion best practices within the team.

Role & Responsibilities:

As a Senior Business Analyst specializing in the Healthcare & Life Sciences (HCLS) domain, with a focus on Provider operations, you will play a pivotal role in understanding, analyzing, and translating complex business needs into actionable technology solutions. You will act as a key liaison between business stakeholders, technical teams, and project management, ensuring successful delivery of initiatives that enhance efficiency, compliance, and patient/provider experience within the provider landscape.

• Patient Access & Intake: Patient registration, scheduling systems, digital intake portals, and eligibility verification (270/271).
• EHR & Clinical Workflows: Core modules (Epic, Cerner/Oracle Health), CPOE, clinical documentation, and clinical decision support integration.
• Revenue Cycle Management (RCM): Charge capture, medical coding (ICD-10, CPT), claim generation (837P/837I, CMS-1500, UB-04), and denial tracking.
• Interoperability & Data Standards: System integration using HL7 v2/v3 messaging, FHIR APIs, C-CDA clinical documents, and HIE connections.
• Ancillary Systems & Quality Compliance: Lab/Radiology workflows (LIS, RIS/PACS), e-Prescribing (Surescripts), and quality reporting (MIPS, eCQMs).

Key Responsibilities:

• Requirements Elicitation & Analysis:
• Lead and facilitate workshops, interviews, and brainstorming sessions with diverse stakeholders (e.g., clinical staff, revenue cycle, IT, patient access, compliance) to elicit, document, and prioritize detailed business requirements.
• Analyze current state processes, identify pain points, and propose future state solutions, leveraging deep understanding of provider operations (e.g., patient registration, scheduling, clinical documentation, charge capture, claims submission, patient billing, referral management).
• Translate high-level business needs into clear, concise, and unambiguous functional and non-functional requirements, user stories, use cases, and process flows (BPMN).
• Collaborate with architects, developers, and product owners to design and validate technical solutions that meet business requirements and align with organizational strategy and industry best practices.
• Evaluate potential solutions, including commercial off-the-shelf (COTS) products (e.g., EHRs, RCM systems) and custom development, performing gap analyses and recommending optimal approaches.
• Contribute to the development of business cases, ROI analyses, and project roadmaps.
• Apply in-depth knowledge of healthcare provider regulations (e.g., HIPAA, HITECH, MIPS/MACRA, state licensing, Stark Law) to ensure all solutions are compliant and mitigate risks.
• Understand and articulate the impact of industry trends such as interoperability (FHIR), telehealth, patient engagement, population health management, and value-based care on provider operations.
• Provide subject matter expertise on various provider settings (e.g., hospitals, clinics, ambulatory surgery centers, long-term care).
• Stakeholder Management & Communication:
• Serve as the primary point of contact for business stakeholders, managing expectations, resolving conflicts, and ensuring alignment throughout the project lifecycle.
• Communicate complex technical concepts to non-technical audiences and business implications to technical teams effectively.
• Prepare and deliver presentations, reports, and documentation to various levels of management and project teams.
• Testing & Quality Assurance Support:
• Define acceptance criteria and support the creation of test plans and test cases.
• Participate in user acceptance testing (UAT) and defect triage, ensuring solutions meet business requirements and quality standards.
• Mentor and guide junior business analysts, fostering their growth and development within the HCLS provider domain.
• Champion best practices in business analysis methodologies and tools.
• Lead small to medium-sized initiatives or workstreams independently.
• Create and maintain comprehensive documentation, including Business Requirements Documents (BRDs), Functional Specification Documents (FSDs), process maps, data flow diagrams, and user manuals.

This role requires a strong analytical mindset, exceptional communication skills, and a proven track record of successfully delivering complex projects within the healthcare provider sector.

Technical Skills:

Must Have

• Process Modeling: Current/future state, optimization (BPMN, Visio).
• Data Analysis: Advanced SQL, Data Visualization (Tableau, Power BI).
• Regulatory Compliance: HIPAA, HITECH, MIPS/MACRA, HL7, FHIR.
• Technical Acumen: API concepts, system integration, database fundamentals.
• Testing Support: Acceptance criteria, UAT.

Leadership Qualities

• Strategic Thinking: Aligning projects with business goals.
• Stakeholder Management: Building relationships, managing expectations.
• Communication: Clear, concise, impactful presentations.
• Mentorship: Guiding and developing junior BAs.
• Problem-Solving: Critical thinking, solution-oriented.
• Influence: Driving consensus, leading without authority.
• Adaptability: Thriving in dynamic environments.

Good to Have

• Agile/Scrum Master Certification: Experience leading Agile ceremonies or certified.
• Product Management Exposure: Understanding of product lifecycle and roadmap contribution.
• Machine Learning/AI Awareness: Familiarity with how AI/ML can impact provider operations (e.g., clinical decision support, predictive analytics for patient outcomes).
• UX/UI Principles: Basic understanding of user experience design for patient portals or clinical applications.
• Specific EHR/RCM Platform Experience: Knowledge of major provider systems (e.g., Epic, Cerner, Meditech, Allscripts, Athenahealth).
• Consulting Background: Experience in client-facing roles, managing multiple projects.
• Certifications: CBAP, CCBA, or other relevant industry certifications.
• Statistical Analysis Tools: Familiarity with R or Python for advanced analytics.