commercial, federal and state government plans specifically support operational
processes for provider data management functions, enrollment and eligibility,
member benefits, claims adjudication and EDI Interfaces functions.
• Knowledge of State regulations to determine provider meets qualification to be
• Knowledge of provider files from State Medicaid programs to decipher provider
enrollment and eligibility rules.
• Knowledge of provider type designation identified by the State Medicaid programs.
• Knowledge of provider and member portal functions.
• Knowledge of provider reimbursement methodologies about Commercial, CMS and
State defined guidelines.
• Knowledge of provider matching criteria for claims.
• Knowledge of Coordination of Benefits (COB) and Claim Authorizations functions.
• Knowledge of Setting up communications for EDI transmissions using FTP, SFTP and
real time API setups
• Knowledge of health insurance, HMO and managed care principles including
Medicaid and Medicare regulation.
• Solid analytical skills with the ability to compile data from many sources and define
designs for enrollment to benefit plan configuration.
• Research, interpret and summarize new state, federal and client rules regarding
department functions. Alter or create policies and procedures to adhere to those
• Solid communication skills with working session facilitation.
• Strong time management, attention to detail, analytic and organizational skills.
• Excellent interpersonal, oral and written communication skills.
• Able to work independently and within a collaborative team environment with little
interviewing stakeholders and team members, using related reports, etc.
*Analyze business processes to understand the problems and their root
causes, distinguish opportunities, and define areas that need
*Based on the independent analysis, find solutions that will boost
product potential and performance on the market.
*Explain the idea and present the plan of its implementation to the
*Discuss the technical implementation for the idea with the development
team to test its feasibility.
*Analyze the feasible solutions within a given budget, deadlines, existing
*Validate the business requirements to make sure that all parties
involved in the development process are on the same page.
Navtech (Navaratan Technologies)
Senior Business Analyst :
Navtech is a premier IT software and Services provider. Navtech's mission is to increase public cloud adoption and build cloud-first solutions that become trendsetting platforms of the future. We have been recognized as the Best Cloud Service Provider at GoodFirms for ensuring good results with quality services. Here, we strive to innovate and push technology and service boundaries to provide best-in-class technology solutions to our clients at scale. We deliver to our clients globally from our state-of-the-art design and development centers in the US, Hyderabad, and Pune.
We're a fast-growing company with clients in the United States, UK, and Europe. You will join a team of talented developers, quality engineers, product managers whose mission is to impact above 100 million people across the world with technological services by the year 2030.
The Sr Business Analyst is responsible for interacting with both clients and product stakeholders and gathering the details around upcoming product requests. You will be investigating the who, what, how and why of how the products at Premiere expand and grow to improve and increase our overall business. Works closely with product stakeholders, customers, client relations teams and support. Also works directly with product management, project management, UI/UX and engineering teams.
Working as an Sr.Business Analyst at Navtech, you will :
- Analyzing, specifying and validating the business needs of stakeholders.
- Collaborating with product teams to determine project scope and vision.
- Working to gather customer requirements across various means (surveys, workshops, meetings).
- Work with stakeholders and project team to prioritize requirements.
- Analyzes and verifies requirements are complete and comprehensive so that they may be passed off to product teams.
- Creates process models, specifications and diagrams to provide direction to product and engineering.
- Works to provide documentation back to stakeholders to ensure requirements were correctly interpreted.
- Racks requirements across product lifecycle and re-define, if needed. 9. Communicate any changes to requirements to stakeholders and customer support teams.
Who Are We Looking For Exactly
- 4+ years' experience in business analytics, business administration or similar role.
- Proven experience with business and technical requirements analysis, elicitation, modeling, verification and methodology development.
- Demonstrated project management skills, project management software skills, including planning, organizing and managing resources.
- Solid understanding of Agile and Atlassian suite of products. Agile-based methodologies.
- Possesses and applies a comprehensive knowledge of technical and/or business knowledge and can learn about our business quickly.
- Works on projects that are moderate to difficult regarding complexity
- Strong customer service orientation.
- Proficient knowledge of Microsoft Office.
- Proficient knowledge with relevant lgal requirements and regulations.
- Strong customer service skills.
- Strong analytical and problem-solving skills.
- Demonstrate critical thinking skills.
- Attention to detail and organization skills.
- Ability to adapt to changing priorities.
- Strong interpersonal abilities and communication skills.
- Ability and interest to work in a geographically diverse environment.
- Media and entertainment experience is a plus.
- Bachelor's Degree in Business Administration or Information Systems required.
- Performance review and Appraisal Twice a year.
- Competitive pay package with additional bonus & benefits.
- Work with US, UK & Europe based industry renowned clients for exponential technical growth.
- Medical Insurance cover for self & family.
- Work with a culturally diverse team from different geographies.
- Determine operational objectives by studying business functions; gathering information; evaluating output requirements and formats
- Construct workflow charts and diagrams; studying system capabilities; writing specifications
- Improve systems by studying current practices; designing modifications
- Recommend controls by identifying problems; writing improved procedures
- Define project requirements by identifying project milestones, phases and elements; forming project team; establishing project budget
- Monitor project progress by tracking activity; resolving problems; publishing progress reports; recommending actions
- Maintain user confidence and protect operations by keeping information confidential
- Prepare technical reports by collecting, analyzing and summarizing information and trends
- Contribute to team effort by accomplishing related results as needed
- Validate resource requirements and develop cost estimate models
- Conduct and coordinate financial, product, market, operational and related research to support strategic and business planning within the various departments and programs of the client group
- Interpret, evaluate and interrelate research data and develop integrated business analyses and projections for incorporation into strategic decision-making
- Plan and coordinate the development of primary and secondary market research studies in support of strategic planning and specific marketing initiatives, as required and presents findings of studies to client committees
- Perform daily, weekly and monthly reviews and analyses of current processes using operational metrics and reports
- Review a variety of areas including operations, purchasing, inventory, distribution and facilities
- Understand and communicate the financial and operational impact of any changes
- Suggest changes to senior management using analytics to support your recommendations. Actively participate in the implementation of approved changes
- Create informative, actionable and repeatable reporting that highlights relevant business trends and opportunities for improvement
- Conduct insightful, ad hoc analyses to investigate ongoing or one-time operational issues
Ø 2+ years of experience in Insurance domain. Knowledge about complete Insurance value chain i.e. Submission, Quotes, Policy Bound, Policy Administration, Claims, Billing and Reinsurance.
Ø Strong documentation skills on feature understanding, tracking of items, maintaining RTM, FSD, Change requests documents, back log/ query log and Share-point folder maintenance for all updates.
Ø Well versed with rating algorithm, policy life cycle management, rule engine handling & payment integration with third party provider.
Business development can be summarized as the ideas, initiatives, and activities that help make a business better.
The target area would be clients looking forward to Digital Marketing services. Hence includes,
- Increasing revenues
- Growth in terms of business expansion,
- Increasing profitability by building strategic partnerships and making strategic business decisions.
- Responsible for prospecting, identifying, and developing business with new customers
- Preparing commercials for prospective clients based on the business offering in consultation with the project manager.
- Introduce the new client to the operations team and assist the operations team to work for the new client.
- Competitor analysis: Should be aware of the work being done by the competition and come up with strategies to acquire those accounts.
- Providing management with client/market feedback.
- Ability to identify client needs and decide deliverables for the same.
- Should be self-driven, target-oriented, and passionate
- Industry Type IT
- Functional Area Sales & Business Development
- Employment Type Full Time, Permanent
- Role Category BD / Pre Sales
- UG: Any Graduate
- PG: Any Postgraduate
- Doctorate: Doctorate Not Required
| Overview Senior Consultant working in the GA Security & Compliance team to support the team in all activities related to Security & Compliance. He/she will be asked to lead some subprojects related to Security & Compliance, driving it to a desired result. Audit or Privacy experience is preferred.
Responsibilities "• Proactively manage any activity that contributes to information safety, compliancy or legal demands
• Create accurate dashboards and effective status updates
• Keep track of closed, open and ‘in progress’ activities"
Required Skills "• Good English writing, verbal and documenting skills is a must
• ITIL foundation
• Ability to use Excel, Word and PowerPoint on a medium level at a minimum
• Self-managed, self-propelled and pro-active attitude
• Able to challenge teams, managers and auditors where appropriate
• Willing and able to present to larger groups of people
• Needs to be familiar with technology, but has not to be a technologist
• Ability to liaise and work with all levels and across teams, internal and external
• Understanding of Identity, Authorization, Authentication and Audit (IAAA) lifecycle including assessments of these areas
• Ability to create effective presentations
Desired Skills "• Preferably able to manage a project
• Preferably CISA or CISSP or willing to study to get this certification
• Aware of privacy and GDPR guidelines, and preferably holds a privacy-related certification, like CIPP, CDPSE or CIPM, or willing to study to get this certification"
Are you looking for a long-term and full-time remote role where you can work with US-based companies? Read on!
What is Wishup?
Wishup is India's leading remote employee platform helping US-based businesses in building highly efficient remote teams. Wishup was founded in 2015 by IITM & IIMA alumni and is backed by marquee investors like Orios Venture Partners, Inflection Point Ventures, Tracxn capital, and Mato Peric.
We are witnessing phenomenal month-on-month growth and stand at a cusp of a revolution in the remote workforce industry. This is your chance to be a part of the revolution - we are inviting applications to work with our US-based clients.
- Prior experience as an Analyst would be a great fit for this role
- The role is remote and full-time (not a freelancing assignment)
- The role would require working in the US time zone
What's in it for you?
- International exposure: You’ll get to interact and build relationships with the smartest global founders and CXOs working on cutting-edge ideas
- No hassle of US visa application; since it’s remote working
- Constant upskilling to maintain market relevance: We provide up to 4 weeks of training
during onboarding in all the latest industry tools and practices
- Stable full-time remote job in a company that has been fully remote for over 5 years: work
from home (or anywhere), forever!
- Scope of rapid growth based on bi-annual appraisals
- A healthy work-life balance
You're a great fit if you have:
- At least 2 years of full-time employment experience
- A stable career employment track record
- Impeccable written and spoken English
- An aptitude for mathematics and logic
- A solid experience in resolving work-conflict situations
- High-speed internet connection
- Laptop with an integrated camera and a pair of headphones
- Distraction-free workspace with zero external interference
- Ability to work with US time zones
- Mon-Fri, 6:30 p.m. - 3:30 a.m. IST
- Mon-Fri, 9:30 p.m. - 6:30 a.m. IST
Social Media Links:
LinkedIn - https://www.linkedin.com/company/wishup-services/" target="_blank">https://www.linkedin.com/
Facebook - https://www.facebook.com/wishupnow/" target="_blank">https://www.facebook.com/
Twitter - https://twitter.com/wishupnow" target="_blank">https://twitter.com/wishupnow
Instagram - https://www.instagram.com/wishupnow/" target="_blank">https://www.instagram.com/
Duties and Responsibilities:
Understanding of business analysis and requirement elicitation techniques (JAD session, Workshops, etc)
Experience of working on Projects, as well as production support experience
Develop an in-depth understanding of customer requirements to create business requirements
Work closely with product owners and end customers to convert business requirements into agile epics and stories
Manage and keep product backlog up-to-date and ensure stories are elaborated before planning events.
Prepare backlog and run meetings during Big Room Planning events to elaborate, define accurate acceptance, prioritize, size and schedule stories into sprints.
Work closely with SCRUM master to record ongoing changes to the user stories as they are being analysed, designed and implemented during the sprints.
Manage the roadmap and sprint reports by keeping epics and stories correctly tagged and status up to date.
Be able to understand various application interactions among systems, functionalities, dependencies, etc.
Collaboration with numerous (>15) teams to manage dependencies for risk items remediation and be able to drive techno-functional discussions independently
Able to understand milestones set by leadership and be able to prepare Work breakdown structure, project plan in order to provide direction to all application teams to prioritize risk items properly and fix them on time in the priority order.
Performing User Acceptance Testing
Proficient with managing and updating project documentation
Detail oriented across multiple teams, while keeping in mind the client’s overall priorities and the big picture.
Business Analyst /Scrum Master experience of at least 5 years
3+ years of experience with agile software development.
Working on agile software development projects and agile SDLC.
Proficient in JIRA, Azure DevOps tool
Prepare presentations for weekly reporting of progress, risks, constraints, etc.
Wireframe and advanced process flow tools
Self-starter with strong self-management skills.
Strong interpersonal, communication and leadership skills.
Ability to organize and manage multiple priorities.
Passion and drive for learning new technologies and practices.
Adaptable, dependable, and independent.
Project Management / Project leading skills are advantageous
CSM or CSPO Certified is preferred
Job Description :
1. Candidate should have Strong SQL skills and manipulate large data sets in a database.
2. Advanced Excel proficiency including Pivot tables, lookup/hookup, graphs, etc.
3. Knowledge and experience in the Banking industry are preferred.
4. Top decile SQL skills are a MUST (Experience in Hive/Spark-SQL is strongly preferred)
5. Should possess a strong combination of analytical, technical, and business savvy.
6. Ability to thrive in a fast-paced start-up environment, and to manage multiple, competing priorities simultaneously.Must be comfortable in ambiguity and constantly evolving environment
Key Responsibilities :
1. Will be the point of contact for reporting/data management needs and will be responsible to drive complex data analysis and propose improvement opportunities in existing tools and reports.
2. The Business Analyst will be responsible to establish best practices in data management, data visualization, and report distribution.
3. Understanding client requirements and converting them into technical and business deliverables.
4. Leverage data warehouse and other data sources to answer business queries.
5. Doing the ad-hoc analysis and presenting results in a clear manner.
A Zone Manager ensures the Sales Strategy for the company is communicated and implemented within a specific Zone for which this role is responsible. Drive achievement of sales and revenue targets and develop a business implementation plan for the zone to ensure that it delivers against its targets.
- Appoint, train and develop new Representatives and Leaders in the zone.
- Achieve Agreed revenue and Active staff count targets and KPI s of the zone.
- Work with Leaders in the zone to develop their business. Observe and Coach Leaders in the PATD process and create a PATD environment in the zone.
- Conduct Communication meetings with Leaders and Representatives in the zone.
- Identify opportunities to grow coverage in the zone as well as drive company initiatives to increase sales in the zone.
Diploma/Graduation/Post Graduation in any stream with experience in a frontline sales, field sale in Direct Selling, FMCG.