Senior Consultant - AI Business Analyst

Role- AI Business Anlayst

Core Skills  - Business Analysis, US Healthcare domain, AI/Gen AI/NLP/ML/DL knowledge.

Role 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.

Also responsible for identification,documentation, and resolution of risks, defects and issues.

Analyzes market trends for competitive insight to correlate into business value statements.

Uses functional and organizational knowledge to mentor Associate and Intermediate Business Systems Analysts. Leads project teams or actively participate as subject matter expert (SME) on moderately complex projects (which are cross functional, with potential regulatory risk exposure, customer service & financial impacts ).

Acts as face to the customer. Resolves very complex issues (may involve multiple systems) while understanding potential regulatory risk exposure and customer service & financial impacts.

Acts as a SME on how moderately complex new enhancements/applications are developed using advanced level of understanding of end-to-end process. clear understanding of potential integration issues

Requires advanced level of understanding the end systems impact of changes across multiple/diverse systems (including regulatory risk exposure, customer service & financial impacts).

Roles & Responsibilities

•Take a lead role with customers, Software Engineers, Architects, Capability Managers, and other team members to capture capability needs and drive quality business solutions on complex issues.

Create and maintain deliverables such as business vision, requirements, testing plan, testing schedule, testing scenarios, testing outcomes, user task analysis, wire framing, usability testing, personalization to different clients, and user interface design.

•Participate in the full software development life cycle by actively taking a lead role on agile scrum teams in various roles, including, but not limited to, Scrum Master, Business Technical Analyst, User Interface designer, Capability Manager, or Tester, based upon experience and need.

•Provide required business and/or subject matter expertise for both project and production related activities on complex issues, including new strategic programs or initiatives impacting current and existing systems.

•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. Required •Bachelor’s or Master’s degree in Information Technology or related field or 6 years of related and progressive experience in lieu

•Candidate must have worked in US healthcare with experience minimum of 4 years, especially in claims application as business analyst or consultant •OSCAR, PBM, RENO, 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 sound knowledge in claims testing end to end, work under minimal supervision and take complete ownership of delivery

•Sound knowledge of current US federal and state laws with regards to healthcare governance and policies, and preferable to have PAHM/FAHM certifications or working towards certification

•Preferable to have basic SQL knowledge

•Business Analysis knowledge is mandatory, and preferable to have certifications like CBA/CBAP or working towards certification

•Should have experience in writing functional specification documents/BRD

•Should have the fundamentals of requirement gathering, elicitation, documenting, and transition over to internal and external stakeholders

•Should have ability to solve the complex business problems and exposed to complete software development life cycle (SDLC)

•Enthusiastic to learn and willing to work in flexible timing, and may require to work on weekend as per business need

Good to have

•Experience in delivery management for US Healthcare Payer customers

•Agile delivery methodology - Nice to have work exposure with agile and scrum teams •Membership and provider domain knowledge/experience is preferable