Senior Healthcare Business Analyst

About the role

Ciklum is hiring a seasoned Business Analyst to support healthcare technology initiatives in Pune. The position sits between US health plan/payer stakeholders and engineering teams, turning business needs into clear, actionable requirements for customer-facing and internal web applications. Strong knowledge of US payer operations, claims processing, and web application workflows is essential.

Key responsibilities

• Run requirement discovery sessions such as JAD workshops, interviews, and working meetings with US clients, product vendors, and operations teams.
• Convert complex payer rules into structured BRDs, FSDs, and Agile user stories with well-defined acceptance criteria, preferably in Gherkin.
• Own and maintain the product backlog, balancing priorities based on compliance dates, business impact, and technical constraints.
• Analyse and improve payer processes including member enrollment, eligibility checks, claims adjudication, billing, and provider network management.
• Make sure web applications align with US healthcare regulations such as HIPAA, ACA, and CMS requirements.
• Work with healthcare EDI transactions including 837, 835, 270/271, and 276/277.
• Partner with UI/UX teams to shape user journeys, wireframes, and mockups for payer administrators and members.
• Define functional needs for portals, dashboards, reporting tools, secure member experiences, and API integrations.
• Review end-to-end data movement between front-end applications and back-end adjudication systems.
• Support QA by reviewing test plans and test cases to ensure complete traceability to requirements.
• Lead UAT sessions with business users, manage defect triage, and help define remediation steps.
• Perform gap analysis between current-state and future-state processes, then translate findings into epics, stories, and related delivery artifacts.
• Carry out additional research where needed to refine healthcare workflow and business requirements for improved solution proposals.
• Maintain tight requirement traceability and enforce change-control discipline to protect fixed-price scope, cost, and timelines.

Requirements

• At least 7 years of business analysis experience, including a minimum of 3 years focused on the US healthcare payer domain.
• Background in managing or delivering enterprise B2B or B2C web applications or web portals.
• Hands-on experience in Agile/Scrum environments with tools such as Jira and Confluence.
• Ability to write intermediate SQL queries for analysis and data profiling.
• Understanding of REST/SOAP services and data formats such as JSON and XML.
• Strong knowledge of US payer concepts including copay, deductibles, coinsurance, out-of-pocket maximums, COB, and ICD-10/CPT coding.
• Excellent written and verbal communication skills, including confidence presenting to senior US stakeholders and working across time zones.

Eligibility

Any graduate can apply.

About Ciklum

Ciklum is a global digital services and software engineering company that works with Fortune 500 and high-growth businesses. Headquartered in the UK, the company brings together more than 4,000 software developers, designers, product managers, and data scientists worldwide to build tailored digital solutions and support digital transformation across major industries.