Senior Business Analyst (Payer)

Quantiphi Analytics Solutions Private Limited; Bengaluru; On-site; INR 1,500,000 - 2,100,000; Full time

Job summary

Quantiphi Analytics Solutions Private Limited in Bangalore is seeking a Senior Business Analyst (Payer) to bridge complex payer needs with technology solutions. You will lead requirements elicitation, process mapping, and data analysis for payer-focused initiatives, ensuring alignment with business goals and regulatory compliance.

You will mentor junior analysts, collaborate with cross-functional teams, and contribute to impact assessments, designing practical, value-driven solutions for

Qualifications

• Elicitation, documentation, prioritization of requirements (JIRA, Azure DevOps).
• Modeling current and future state processes (BPMN, Visio).
• Advanced SQL and data visualization (Tableau, Power BI).
• Payer domain knowledge: claims, enrollment, provider networks, benefits.
• Regulatory compliance: HIPAA, ACA, CMS, X12 EDI, FHIR.
• API concepts, system integration, database fundamentals.
• Acceptance criteria definition and UAT support.
• Comprehensive project artifacts and documentation.

Responsibilities

• Lead requirements elicitation, documentation and prioritization with diverse stakeholders.
• Translate business needs into functional and non-functional specifications and user stories.
• Collaborate with architects, developers and product owners to design compliant solutions.
• Evaluate COTS vs custom solutions and contribute to ROI analyses and roadmaps.
• Ensure payer regulations are incorporated and aligned with business objectives.
• Support testing, UAT and defect triage; create BRDs and FSDs and process maps.

Skills

Requirements Expertise

Process Modeling

Data Analysis

Payer Domain Knowledge

Regulatory Compliance

Technical Acumen

Testing Support

Documentation

Tools

JIRA

Azure DevOps

Tableau

Power BI

Visio

BPMN

Job description

While technology is the heart of our business, a global and diverse culture is the heart of our success. We love our people and we take pride in catering them to a culture built on transparency, diversity, integrity, learning and growth. If working in an environment that encourages you to innovate and excel, not just in professional but personal life, interests you- you would enjoy your career with Quantiphi!

Role: Senior Business Analyst - Payer Experience Level: 4 to 7 years Work location: Bangalore

What you’ll do:

As a Senior Business Analyst (Payer) in HCLS, you'll be the bridge between complex healthcare payer needs and innovative technology solutions. You'll lead requirements gathering, process mapping, and data analysis for payer-focused projects (e.g., claims processing, provider networks, member engagement). Your expertise in payer operations, regulatory compliance (HIPAA, CMS), 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 Payer 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 member/provider experience within the payer landscape.

Requirements Elicitation & Analysis:

Lead and facilitate workshops, interviews, and brainstorming sessions with diverse stakeholders (e.g., claims, enrollment, provider relations, finance, 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 payer operations (e.g., claims adjudication, benefit configuration, premium billing, member services, provider contracting).

Translate high-level business needs into clear, concise, and unambiguous functional and non-functional requirements, user stories, use cases, and process flows (BPMN).

Solution Design & Strategy:

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 and custom development, performing gap analyses and recommending optimal approaches.

Contribute to the development of business cases, ROI analyses, and project roadmaps.

Payer Domain Expertise & Compliance:

Apply in-depth knowledge of healthcare payer regulations (e.g., HIPAA, ACA, CMS guidelines, state mandates) to ensure all solutions are compliant and mitigate risks.

Understand and articulate the impact of industry trends such as value-based care, interoperability (FHIR), digital transformation, and consumerism on payer operations.

Provide subject matter expertise on various payer lines of business (e.g., Commercial, Medicare, Medicaid, Exchange).

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.

Documentation & Artifacts:

Create and maintain comprehensive documentation, including Business Requirements Documents (BRDs), Functional Specification Documents (FSDs), process maps, data flow diagrams, and user manuals.

Must Have Skills:

• Requirements Expertise: Elicitation, documentation, prioritization (JIRA, Azure DevOps).
• Process Modeling: Current/future state, optimization (BPMN, Visio).
• Data Analysis: Advanced SQL, Data Visualization (Tableau, Power BI).
• Payer Domain Knowledge: Claims, enrollment, provider networks, benefits.
• Regulatory Compliance: HIPAA, ACA, CMS, X12 EDI, FHIR.
• Technical Acumen: API concepts, system integration, database fundamentals.
• Testing Support: Acceptance criteria, UAT.
• Documentation: Comprehensive project artifacts.

If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!

Thank you for your interest in Quantiphi! We are a team that dreams together and collaborates to ensure success. We are currently looking for exceptional individuals who can join us and contribute to a fun, diverse and hybrid work culture. As a part of the Quantiphi family, you will get ample opportunities to learn, grow and interact with colleagues from varied experience and backgrounds around the globe.

Quantiphi is an award-winning AI-first digital engineering company driven by the desire to reimagine and realize transformational opportunities at the heart of business. We solve the toughest and most complex business problems with the latest and cutting-edge technologies and to make this happen, we have a vibrant, diverse and talented set of professionals we proudly refer to as the Quantiphi family. Our culture is built on transparency, diversity, integrity, learning and growth. We are committed to provide our teams with an environment that helps them to learn, grow and flourish in their professional as well as personal lives.