Role Purpose
The purpose of this role is to perform initial business analysis and create basic process documents in line with defined guidelines to assist team members in understanding client requirements and supporting early-stage analysis and documentation activities.
Role: Business Analyst (Healthcare Payer)
Location: Louisville, Kentucky
Required Qualifications
• Bachelor's degree in Business Administration, Healthcare Administration, Information Systems, or a related field.
• Strong experience in healthcare payer operations and business analysis.
• Deep understanding of healthcare payer functions, including:
o Enrollment and Eligibility
o Claims Processing and Adjudication
o Provider Network and Contract Management
o Utilization Management
o Care Management
o Customer Service Operations
o Payment Integrity
o Appeals and Grievances
• Experience gathering and documenting business and functional requirements.
• Strong analytical, communication, facilitation, and stakeholder management skills.
• Experience working in Agile and Waterfall delivery environments.
Preferred Qualifications
• Experience with Medicare, Medicaid, Commercial, and Dual-Eligible healthcare programs.
• Knowledge of healthcare standards such as FHIR, HL7, EDI X12, HEDIS, STAR Ratings, and CMS regulations.
• Experience supporting payer modernization, digital transformation, data management, analytics, or AI-enabled initiatives.
• Familiarity with healthcare platforms such as Facets, QNXT, HealthRules, Epic, or related payer.
Mandatory Skills: HC - Payor
Experience: 3-5 Years
The expected compensation for this role ranges from $45,000 to $110,000 .
Final compensation will depend on various factors, including your geographical location, minimum wage obligations, skills, and relevant experience. Based on the position, the role is also eligible for Wipro's standard benefits including a full range of medical and dental benefits options, disability insurance, paid time off (inclusive of sick leave), other paid and unpaid leave options.
Applicants are advised that employment in some roles may be conditioned on successful completion of a post-offer drug screening, subject to applicable state law.
Wipro provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. Applications from veterans and people with disabilities are explicitly welcome.
Reinvent your world. We are building a modern Wipro. We are an end-to-end digital transformation partner with the boldest ambitions. To realize them, we need people inspired by reinvention. Of yourself, your career, and your skills. We want to see the constant evolution of our business and our industry. It has always been in our DNA - as the world around us changes, so do we. Join a business powered by purpose and a place that empowers you to design your own reinvention.
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