We need someone who can:

Work with the clients to create/gather requirements and document them according to standards.

Adhere to (or if needed, define) the processes for requirement solicitation, documentation and hand off

Work closely with the development team to elucidate the requirements, enable constructive discussions / brainstorming sessions to implement the best in class solution.

Demonstrate basic understanding concepts like web services, relational databases etc.,

Run queries and perform basic system analysis, RCA etc.,

Create mapping documents for the various interfaces and include business rules, transformation and DB mapping.

Work closely with the client and development team during the stages of development, and conduct demos at completion of milestone, track and close feedback from such demos

Display excellent written and spoken communication skills. Should be able to multitask between internal team and clients based on priority tasks

Work Closely with Development, architecture and Design teams to define the GUI view and platform requirements, which is the foundation of the product

Think out-of-the-box to create new solutions as needed

Demonstrate excellent communication (written and spoken ) skills to engage with different stake holders like QA/dev team, clients, end users of Clients and Business Units

Assess current functionality available in a product vis a vis market trends, regulatory requirements to be implemented in future version of the product

Drive and share the requirements with Technical and Architects regarding product features to be implemented

Minimum Qualifications For Consideration:

Bachelors Degree or equivalent working experience

Must have very good understanding of the healthcare payer space with a minimum experience of 5 years in the domain

Must have a prior experience in implementing/maintenance of commercial payer solution and/or Medicaid system

Must have good experience with claims processing concepts, along with the member enrolment and care management concepts

Preferred Qualifications For Consideration:

Prior experience as a QA or Developer in a healthcare system would be helpful though not mandatory.

Ability to validate Test scenarios and test plans, test data.

Review requirements, documentation and create Requirements Traceability matrix (RTM)

MS Visio to define the different views like System, technical, functional and role based view

Awareness defect tracking and version control tools like Jira, TFM, DevOps Azure

DB client to write data queries to validate data updated in the database table