Medicare Advantage Regulatory & Compliance Strategist

Infosys

Tempe (AZ)

On-site

USD 95,000 - 135,000

Full time

8 days ago
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Benefits offered by this job

Medical Insurance
Dental Insurance
Vision Insurance
Long-term/Short-term Disability
401(k)
Paid holidays
Paid Time Off

Job summary

Infosys Healthcare is seeking a Product Consultant 2 to analyze requirements, document customer needs, and define product features in a regulated US healthcare context. You will perform market analysis, participate in competitive risk assessments, and support architectural design and system integration.

Collaboration with cross‑functional teams to ensure alignment with design goals is essential. You will help develop prototypes, maintenance procedures, and tailored solutions, while ensuring

Qualifications

  • Medicare related regulations, FDR oversight and audit requirements, HIPAA , FHIR.
  • Strong understanding of healthcare payer operations.
  • Experience in regulatory compliance roles for US healthcare with deep expertise in Medicare Advantage programs.
  • Experience in developing HIPAA compliant applications/ operational processes.
  • Experience participating in CMS audits for Medicare advantage.
  • Experience in compliance program administration including risk assessments, policy creation, training, monitoring and reporting, audits and investigations.

Responsibilities

  • Assist in analyzing functional and non‑functional requirements and technical feasibility of product features to be implemented.
  • Document customer requirements and analyze the requirements gathered, ensuring that all relevant information is captured for further development.
  • Conduct market study and analysis to enable definition of product requirements and features.
  • Actively participate in competitive analysis and risk assessments.
  • Assist in creation of architectural designs and structure of the product, while supporting the evaluation of technology frameworks.
  • Participate in product scalability and product performance assessments and assist in planning for integration with existing system.
  • Identify and define product design concepts, create prototypes and structure user experience elements.
  • Collaborate with cross‑functional teams to ensure alignment with design goals.
  • Participate in the development of small features and enhancements, while contributing to specific tasks within the development process.
  • Collaborate with internal stakeholders to gather specific customer needs and translate them into actionable development tasks.
  • Maintain documentation of the development process, ensuring alignment with customer expectations.
  • Conduct quality checks on development activities, while ensuring defined standards are met.
  • Conduct customer discussions to understand their requirements, while identifying customization options.
  • Contribute to creation of structured proposals and assist in developing tailored solutions that meet customer needs.
  • Refine documentation of the customization processes and co‑ordinate with cross‑functional teams to ensure alignment.
  • Develop implementation checklist to ensure all necessary steps and requirements are addressed during the integration process.
  • Assist in gathering system specifications, documenting integration procedures, and supporting the setup of necessary tools and resources.
  • Coordinate with stakeholders to facilitate smooth communication throughout the implementation phase.
  • Participate in production issue analysis and support resolution processes by logging incidents and validating fixes.
  • Maintain SOPs and operational user manual to ensure system stability.
  • Interact with client stakeholders when required, to resolve issues, ensuring timely responses and product fixes, along with internal stakeholders.
  • Draft SOPs, user guides, and workflow documentation based on team inputs.
  • Collaborate with team members to maintain accuracy in documentation repositories.
  • Maintain detailed records of work completed, learnings captured, and product behavior observed during rollouts.
  • Participate in knowledge transfer sessions and contribute to internal repositories.

Skills

Medicare regs
HIPAA
FHIR
CMS audits
Payer operations

Education

Bachelor's degree

Job description

Infosys Healthcare is seeking a Product Consultant 2 to analyze requirements, document customer needs, and define product features in a regulated US healthcare context. You will perform market analysis, participate in competitive risk assessments, and support architectural design and system integration.

Collaboration with cross‑functional teams to ensure alignment with design goals is essential. You will help develop prototypes, maintenance procedures, and tailored solutions, while ensuring

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