Role Description
Role Proficiency:Contributes to driving the Product Vision that addresses cross-domain market needs with strong business viability; in line with the Product/Platform Portfolio with guidance from Managers. Assists Managers in delivering the desired product and platform outcomes from original inspiration through implementation and support.rnContributes to the discovery and development of the product/platform per the phases and stages of the product/platform. as guided by the Product Managers.
Outcomes
- A strong evangelist of Product & Platforms Division’s Vision and Philosophy.
- Performs primary and secondary research on Market Driven Products & Platforms; executes the product/platform strategy
- Ensures clear and unambiguous translation of Product Value Roadmap through deliverables to enable the product team to complete work
- Ensures adherence to the Product Value Roadmap set by Product Managers and Product Leadership
- Drafts user stories and ensures they are clearly understood by cross functional product teams
- Ensures Product requirements are gathered and prioritized
- Drives the execution of product development in collaboration with Product Team members comprised of Product Design Technology & Data Science
- Adherence to the modern product management practises and standards; providing periodic status updates
- Supports Product Managers and Senior Product Managers in product demos
- Supports in achieving the Product OKR's
Measures Of Outcomes
- Adherence to agreed product roll-out timelines
- Achievement of Product Metrics
- Achievement of Product OKR's
- Product Team Performance
- Number of domain and product certifications
Outputs Expected
Plan to develop great products and platforms:
- Strong research enabling sound Product Discovery
- Co-facilitates Discovery Sprints under guidance from Product and Senior Product Managers
- Write and articulate great user stories by capturing and translating solutions for identified user problems into product features that deliver value and impress users
- Adherence to Product OKR's
Design To Deliver Vast End -user Experience
- Facilitate sound user research across target market segments
- Influence in implementing design user-centric experiences throughout the user's journey
- Assist in defining user experience (e.g. wire framing journey maps); partnering with product designers
Research The Market To Ensure An Unfair Advantage
- Sound understanding of market trends partner ecosystems and competitive strategies
- Understanding users the marketplace the competition and future trends for the domain or type of system being developed through customer and market research competitive analysis and rapidly acquiring domain expertise
- Define and articulate unique product and business differentiation
Manage business to go to and win in the markets:
- Assist in implementing the GTM strategies and achieve the metrics for product success
- Protect assets and mitigate risks employing IP knowledge
Manage Great People
- Inspire Product teams communicate with diverse groups and influence change throughout the organization
Use Great Technology
- Good understanding and usage of tech stacks
- Good understanding of exponential technologies including AI/ML IoT Blockchain
- Agile proficiency for Rapid Product Discovery & Development
- Employ eminent technology in product management by diving deep into technology trends and architectures
Employ Great Methods In Product Management
- Understand different product management and development approaches
- Understand product usage models
Skill Examples
- Skill in understanding and articulating the core positioning messaging and value propositions for the product
- Ability to support product demos to customers/end users
- Ability to define the user experience to be incorporated into the User Design
- Aptitude in creating user stories
- Ability to creates market customer and competition research based on understanding of market trends partner ecosystems and competitive strategies
- Capable of motivating the team to build and deliver impressive products
Knowledge Examples
Knowledge Examples
- Domain / Industry Knowledge: Working knowledge of standard business processes within the relevant industry vertical and customer business domain
- Technology Trends Knowledge: Demonstrates broad knowledge of technology trends related to multiple inter-related technologies
- Proficient in user story writing
- Knowledge of market trends partner ecosystems and competitive strategies
- Proficient in product documentation
- Expertise in people management
- Knowledge of technology trends and architectures
Additional Comments
Business Analyst Location: Offshore (Kochi, Trivandrum, Chennai) Type: Full-time Role Overview As a Business Analyst, you’ll partner with Health Plans, external vendors, and cross-functional teams to translate complex US healthcare business needs into detailed requirements for our Enrollment and Billing platforms. You’ll cover everything from member onboarding through premium billing reconciliation, ensuring compliance with CMS rules, HIPAA, and industry standards. Key Responsibilities 1. Enrollment Stream
- Groups & Sub-Groups Configuration: Define plan structures, benefit groupings, and sub-group hierarchies.
- Member Lifecycle Management: Gather requirements for New Applications, Plan Benefit Period (PBP) Changes, Disenrollments, Reinstatements, and Membership Updates.
- Eligibility & Enrollment Transactions: Specify inbound/outbound EDI (834, 270/271), AppOut/MembershipOut files, and CMS-mandated reporting.
- Work Queues & Exception Handling: Model Work, Process, and Rejection Queues (including BEQ), and build requirements for automatic routing and SLA tracking.
- Provider & PCP Integrations: Document interfaces to provider directories, PCP assignment engines, PBMs, and claims adjudication systems.
- Vendor File Management: Define ingestion and validation for external vendor feeds (network updates, pharmacy eligibility, premium billing).
- Correspondence & Communications: Capture requirements for letters, invoices, extracts, and digital notifications.
- Regulatory Reporting & Analytics: Elicit requirements for CMS compliance reports, LIS/LEP calculations, and custom dashboards. 2. Billing Stream
- Claims-to-Cash Workflows: Define end-to-end processes for Payment, Invoice, Retro-Billing, LIS/LEP adjustments, PWO (Premium Withhold Override), and DTRR reconciliation.
- Transaction Standards: Specify EDI (835ERAs, 820 Payment Orders, 277CA), ACH files, MMR/MPWR feeds, and XML-based invoice PDFs.
- Invoice Generation & Posting: Document rules for auto-posting, manual adjustments, and multi-LOB invoicing across Commercial, MA, and Medicaid.
- Reconciliation & Reporting: Model data flows for financial reconciliation, exception-driven reruns, and audit-ready reporting. 3. Analysis & Documentation
- Lead discovery sessions—workshops, storyboards, use-cases—to capture granular business rules.
- Create process maps, swim-lane diagrams, data-mapping matrices, and requirement traceability matrices.
- Author BRDs, FRDs, user stories, acceptance criteria, and test-case templates.
- Partner with QA to validate end-to-end scenarios, edge cases, and compliance checks. 4. Stakeholder Engagement & Continuous Improvement
- Facilitate alignment across onshore/offshore teams, operations, vendor partners, and CMS contacts.
- Drive retrospectives to refine requirements-gathering processes, stemming root-cause analysis of production exceptions (e.g., DTRR, premium anomalies).
- Mentor junior analysts on healthcare regulations, EDI standards, and best practices. You Bring
- 7+ years as a BA in US healthcare Enrollment and/or Billing systems.
- Deep expertise in CMS enrollment/disenrollment guidance, EDI (834/270/271, 835/820/277), DTRR, LIS/LEP, and provider network integrations.
- Strong analytical, process-modeling, and documentation skills (Visio/Miro, Jira/Aha).
- Excellent communication, stakeholder management, and facilitation abilities.
- Bachelor’s degree in Business, Healthcare Informatics, or related field.
Skills
Product Owner,Healthcare,Business Analysis,Sdlc
