9 - 12 Years
2 Openings
Chennai, Kochi, Trivandrum
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:
Measures of Outcomes:
Outputs Expected:
Plan to develop great products and platforms:
Design to deliver vast end -user experience:
journey maps); partnering with product designers
Research the market to ensure an unfair advantage:
partner ecosystems
and competitive strategies
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
Manage business to go to and win in the markets:
employing IP knowledge
Manage great people:
communicate with diverse groups
and influence change throughout the organization
Use great technology:
IoT
Blockchain
Employ great methods in product management :
Skill Examples:
Knowledge Examples:
Knowledge Examples
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.
Product Owner,Healthcare,Business Analysis,Sdlc
UST is a global digital transformation solutions provider. For more than 20 years, UST has worked side by side with the world’s best companies to make a real impact through transformation. Powered by technology, inspired by people and led by purpose, UST partners with their clients from design to operation. With deep domain expertise and a future-proof philosophy, UST embeds innovation and agility into their clients’ organizations. With over 30,000 employees in 30 countries, UST builds for boundless impact—touching billions of lives in the process.
Hourly based
TN , India TN, India
TN , India TN, India