Business Analyst (US Healthcare ) – Medicaid

Job Description: Business Analyst (US Healthcare)

Location: Bangalore, Chennai, Tirupati

Experience: 4–8 years

Domain: US Healthcare Payer Domain with specific knowledge of Medicaid and Medicare programs.

Role Overview: We are looking for a Healthcare Business Analyst with strong domain knowledge in the US Payer space with specific knowledge of process and data related to Medicaid and Medicare programs. 

Key Responsibilities

• Act as a domain SME for US Medicaid programs, including eligibility, claims, encounters, managed care, and reporting
• Gather and document business requirements, functional specs, and data mappings for healthcare data platforms
• Support data discovery and profiling for payer and state Medicaid & Medicare datasets
• Translate regulatory and program requirements into clear, implementable artifacts
• Participate in client discussions, clarifications, and walkthroughs
• Assist with UAT planning, test cases, and validation of healthcare data outputs

Required Skills & Experience

• 4+ years of experience as a Healthcare Business Analyst in US healthcare payer space
• Strong hands-on knowledge of Medicaid programs
• Familiarity with payer data domains:
• Member
• Provider
• Claims
• Encounters
• Ability to write clear BRDs, FRDs, and data mapping documents
• Strong communication skills and ability to work with US clients

Good to Have

• Exposure to FHIR (R4/R5) and interoperability initiatives
• Familiarity with CMS, T-MSIS, HEDIS, or state Medicaid reporting
• Experience working with payer or state Medicaid systems
• Prior experience working with US-based product or platform teams