Senior Business Analyst- Healthcare (Medical Network Management)

PureSoftware Pvt Ltd; Malaysia; On-site; MYR 60,000 - 80,000; Full time

Job summary

A leading healthcare technology firm in Malaysia is looking for a Business Analyst to support Medical Network Management. The role includes analyzing and documenting business requirements related to claims processing, collaborating with various stakeholders, and ensuring compliance with healthcare regulations. Candidates should have experience in Agile and Waterfall methodologies, along with strong business analysis skills. This position offers an opportunity to improve medical network and claims processes.

Qualifications

• Experience in business analysis within the healthcare sector.
• Knowledge of Medicare and Medicaid compliance.
• Ability to work in Agile and Waterfall methodologies.

Responsibilities

• Act as a functional Business Analyst for Medical Network Management.
• Gather, analyze, and document business requirements.
• Support end-to-end claims lifecycle and ensure data accuracy.

Skills

Business analysis

Agile methodologies

Healthcare compliance

Documentation

Job description

Roles and Responsibilities

• Act as a functional Business Analyst for Medical Network Management, supporting provider setup, contracting, and network configuration initiatives.
• Gather, analyze, and document business requirements related to claims processing, provider networks, RCM, and compliance (Medicare/Medicaid).
• Collaborate with stakeholders, payers, providers, and technical teams to translate healthcare business needs into functional specifications and user stories.
• Support end-to-end claims lifecycle, including network alignment, reimbursement rules, and provider data accuracy.
• Work in Agile and Waterfall environments, participating in sprint planning, backlog grooming, UAT, and deployment activities.
• Ensure adherence to healthcare regulations such as HIPAA, CMS guidelines, and payer‑specific policies.
• Coordinate with QA and testing teams to validate network management and claims‑related enhancements.
• Prepare status reports, conduct stakeholder reviews, and support continuous improvement of medical network and claims processes.