Job Title: Senior Healthcare Business Analyst (SME Level)

Location: Hyderabad, India (Hybrid 3 Days/Week Work from Office)

Employment Type: Full-Time

Shift Timing: 12:00 PM 8:00 PM IST (Overlap with US Business Hours)

Experience Required :10+ Years

Domain: US Healthcare Payer / Health Plan

Lines of Business

- Medicare
- Medicaid
- Employer Group (Commercial)
- Individual & Family (ACA)

We re hiring for one of the top IT services companies.

SPADTEK Solutions is proud to collaborate with leading IT organizations to source exceptional talent for their full-time and Contract positions. Client/Implementation Partner is a globally recognized IT services and consulting company, trusted by Fortune 500 clients and enterprises worldwide. With a strong presence across cloud, data engineering, AI, and digital transformation and is known for delivering cutting-edge solutions that drive business growth and innovation. Working on enterprise-scale projects with global clients. Exposure to next-gen technologies across cloud, data, and digital platforms. A culture that values continuous learning, collaboration, and career growth. Being part of a company consistently ranked among the top IT employers. If you are an experienced professional seeking a long-term career opportunity with one of the industry s most respected names, this is your chance to join top IT services company through SPADTEK Solutions.

Job Summary

We are seeking a highly experienced Senior Healthcare Business Analyst (SME Level) to lead business and technology initiatives for a US Healthcare Payer organization. The ideal candidate will possess deep expertise in Health Plan operations across Medicare, Medicaid, Employer Group, and Individual & Family lines of business.

This role serves as a key liaison between business stakeholders, PMO, IT teams, and vendors to gather requirements, drive analysis, support testing activities, and ensure successful project delivery. The candidate should demonstrate strong communication, stakeholder management, analytical thinking, and leadership capabilities while mentoring junior analysts and driving best practices across projects.

Key Responsibilities

Business Analysis & Requirements Management

- Collaborate with business stakeholders, PMO, IT teams, and vendors to gather,



analyze, and document business and functional requirements.
- Translate business needs into clear, actionable requirements and user stories.
- Develop business requirement documents (BRDs), functional specifications, use cases, process flows, and impact assessments.
- Conduct gap analysis and recommend process improvements and business solutions.

Stakeholder & Project Coordination

- Facilitate workshops, meetings, requirement gathering sessions, and stakeholder discussions.
- Present project updates, findings, recommendations, and risks to leadership and project teams.
- Coordinate with cross-functional teams to manage dependencies and ensure alignment throughout the project lifecycle.
- Maintain requirement traceability and project documentation.

Healthcare Domain Expertise

- Support initiatives across:
- Medicare Advantage, Part D, and Dual Eligible (D-SNP) programs
- Medicaid Managed Care programs
- Commercial/Employer Group plans
- Individual & Family (ACA Marketplace) plans

- Analyze healthcare business processes related to enrollment, eligibility, claims, benefits, provider management, and member services.

Testing & Quality Assurance

- Define and review test scenarios, test cases, and acceptance criteria.
- Support User Acceptance Testing (UAT) activities.
- Track defects, coordinate issue resolution, and validate successful implementation.
- Ensure delivered solutions meet business requirements and quality standards.

Leadership & Mentoring

- Mentor junior Business Analysts and provide guidance on documentation standards and best practices.
- Act as a subject matter expert (SME) for healthcare payer business processes.
- Drive continuous improvement initiatives within the Business Analysis function.

Required Skills & Qualifications

Education

- Bachelors Degree in Business Administration, Healthcare Administration, Computer Science, Information Systems,



Finance, or a related field.

Experience

- 10+ years of Business Analysis experience.
- Strong experience in US Healthcare Payer/Health Plan domain.
- Experience working across one or more lines of business:
- Medicare
- Medicaid
- Commercial/Employer Group
- ACA/Individual Plans

Functional Skills

- Expertise in requirements gathering, analysis, and documentation.
- Strong understanding of healthcare payer operations and business processes.
- Experience creating:
- BRDs
- FRDs
- User Stories
- Use Cases
- Process Flow Diagrams
- Test Cases
- Traceability Matrices

Technical Skills

- Proficiency with:
- JIRA
- Confluence
- Azure DevOps
- Microsoft Visio
- Microsoft Excel
- Microsoft PowerPoint

- Strong knowledge of Agile and Waterfall methodologies.

Soft Skills

- Excellent verbal and written communication skills.
- Strong stakeholder management and presentation abilities.
- Analytical mindset with exceptional attention to detail.
- Ability to manage multiple projects and priorities simultaneously.
- Strong leadership, collaboration, and mentoring capabilities.

Valuable to Have

- Working knowledge of SQL for data analysis, validation, and reporting.
- Familiarity with healthcare regulations and compliance standards:
- HIPAA
- CMS Guidelines
- NCQA Standards
- State Medicaid Regulations

- Experience working with vendor-based healthcare platforms and configurable solutions.
- Exposure to healthcare enrollment, claims processing, care management, provider management, or member services systems.
- Experience supporting large-scale healthcare transformation and modernization initiatives.

Core Competencies

- Healthcare Payer Domain Expertise
- Business Analysis & Requirement Management
- Stakeholder Engagement
- Process Improvement & Problem Solving
- Testing & Quality Assurance
- Leadership & Mentoring
- Communication & Presentation Skills
- Project Coordination & Delivery Management
- Cross-Functional Collaboration

Disclaimer : This job posting has been aggregated from external source. Role details, content, and availability are subject to change. Applicants are advised to confirm the latest information directly on the company website before applying.

📌 Senior Healthcare Business Analyst (SME Level) (Hyderabad)
🏢 Spadtek Solutions
📍 Hyderabad