Healthcare Business Analyst

Wipro

8 - 13 years

15 - 20 Lacs

Hyderabad Pune Chennai

Posted:7 months ago

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Job Description

Experience:

Act as Business Analyst & SME for CMS STAR Ratings, HEDIS, and HEI
Build endtoend quality measurement blueprints and process flows
Create BRDs, FRDs, and detailed business, functional, and data requirements
Translate CMS/HEDIS specifications for engineering and data teams
Identify AI & automation use cases (gap prediction, chart abstraction, outreach)
Collaborate with business, clinical, data, and engineering stakeholders
Support sprint reviews, UAT, validation, and CMS audit readiness

Mandatory

STAR Ratings, HEDIS, CMS Quality Measures
Healthcare Business Analysis (BRD, FRD, Process Mapping)
Claims, Encounters, Pharmacy, Lab & EHR data
Medicare / Medicaid payer experience

Good to Have

HEI, SDOH, Health Equity measures
AI / Advanced Analytics exposure
CMS audits or measure validation experience

Skills Required

hedis healthcare ehr business analysis healthcare insurance healthcare analytics medicare us healthcare claims adjudication

Work Mode

Hybrid

Job Type

Full Time

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