AddressJOB SUMMARY
This job supports one or more analytical aspects of the application product life cycle, including capability enablement with cross-team dependencies within a product scope. Uses significant judgement and discretion to collaborate with customers on complex issues in order to understand capability needs, gather project specifications, create business cases and cost sheet analysis, translate high-level business needs into detailed requirements for new capabilities (and change request/enhancements on existing capabilities), analyze data to determine business problems, trends, or opportunities for process improvements, create/execute test cases, provide root cause analysis and corrective action plan, verify delivery of customer needs, and ensure quality delivery.
Candidate must have worked in US healthcare with experience minimum of 4 years, especially in claims application as Business Analyst or consultant. Membership and provider domain knowledge/experience is preferable, but must have claims knowledge FEP, ITS (Interplan Teleprocessing system)/Blue card claims and B2 application knowledge/experience is preferable. Work experience in EHR/EMR is also considered, but must have worked or possess knowledge of claims submission to Payers. Should have knowledge in working with all types of claim - medical, hospital, Pharmacy, Dental, Vision, Blue card/ITS etc. Should have the fundamentals of requirement gathering, elicitation, documenting, and transition over to internal and external stakeholders. Should have experience in writing functional specification documents/BRD.
ESSENTIAL RESPONSIBILITIES
Ensure compliance for required standards and all necessary approvals have been obtained throughout the project lifecycle.
Interface with the business areas, customers, partners, vendors, technical staff and project teams to drive value, return on investments and innovative solutions. This includes providing alternative solutions, including vendor solution acquisitions, with maximum benefits while reducing cost (e.g. cost benefit analysis, pros/cons of solutions).
Take lead role in supporting various aspects of requirements testing (e.g. testing plan, scenarios, documentation, defect management) to ensure minimal production defects are realized and completing analysis of the results tying back to customer impacts.
Communicate in an exemplary manner with team members, customers, partners and management, including assisting with or conducting requirement walkthroughs and sprint reviews, reporting project status, enabling vendor solutions and providing accurate and concise documentation.
Provide thought leadership and strategic direction in Product and Technology Solutions.
Other duties as assigned.
Must to Have:
6 - 9 years in IS/IT
Min 6 years in the Healthcare Industry
Analytical Skills
Problem-Solving
Communication Skills
Report Writing
SQL
Customer Service
Leadership
Agile Methodology
Shift Expectation: 11Am-8Pm/3Pm-12Am
About Virtusa
Teamwork, quality of life, professional and personal development: values that Virtusa is proud to embody. When you join us, you join a team of 30,000 people globally that cares about your growth — one that seeks to provide you with exciting projects, opportunities and work with state of the art technologies throughout your career with us.
Great minds, great potential: it all comes together at Virtusa. We value collaboration and the team environment of our company, and seek to provide great minds with a dynamic place to nurture new ideas and foster excellence.
Virtusa was founded on principles of equal opportunity for all, and so does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other basis covered by appropriate law. All employment is decided on the basis of qualifications, merit, and business need.
