Job Opportunities

Business Analyst for Digital Health application

Job Description
The Business Analyst will be responsible for defining, optimizing, and implementing processes related to provider performance monitoring within a new insurance provider management system. The role involves translating business needs into clear system requirements, collaborating with cross-functional teams, and ensuring seamless integration with claims, fraud control, finance, and TPA systems.

Key Responsibilities
Map the complete end-to-end provider lifecycle including empanelment, contracting, rate negotiation and management, onboarding, performance monitoring, and delisting.
Define the provider master structure, including mandatory data attributes and classification logic, to support robust system design.
Design multi-level approval workflows for hospital empanelment, credentialing, rate revisions, and periodic revalidation.
Establish and document interfaces and integration points with claims administration, fraud control units, finance, policy servicing, and TPA systems, enabling accurate settlements and operational alignment.
Define data capture and reporting requirements for IRDAI compliance and internal MIS, including cashless network strength, provider categories, and SLA adherence.
Participate in UAT, integration testing, and validation of the provider portal and related modules, including functional flows with TPAs and partner systems.
Support creation of SOPs, business rules, and configuration guidelines for provider network operations.
Collaborate with IT, QA, product, and operations teams to ensure accurate translation of business logic into technical specifications.
Requirements
4–5 years of experience in provider network management, health insurance operations, or system design for provider portals.
Hands-on experience with provider contracting, empanelment tools, or tariff management systems.
Strong analytical skills with the ability to build process maps, workflows, and business rules.
Understanding of ICD, DRG, procedure/tariff codes, and insurance tariff structures.
Familiarity with IRDAI provider-related norms, including disclosure requirements and SLA guidelines.
Proven ability to convert business processes into structured functional requirements and configuration logic.
Skilled in as-is/to-be analysis, gap assessment, and solution design for core insurance or provider management systems.
Experience working closely with IT development, QA teams, and cross-functional stakeholders.
Excellent documentation, communication, and stakeholder management skills.
Your benefits
adesso Cares "You Count" is an integral aspect of our adesso culture. For us, adessis are more than just employees who perform well; we take genuine interest in them as individuals, understanding their needs and motivations. We believe that we walk a shared path with our adessis, one that encompasses not only their career journey but also their life journey.
Continued Learning "Let`s Grow Together" - We genuinely believe in the power of ongoing education to help you achieve your personal and professional goals, regardless of your age or level of experience.
Our Family, Our Anchor We firmly believe that every adessi's anchor and support is their own family. And, in turn, the adessis form the essence of the adesso family. Therefore, it is of utmost importance for us to harmonize these two aspects and create a Work-Life Blend.