Practice Business Analyst - Health/Insurance Domain

Description :

Position : Practice Business Analyst (Data, Reporting & AI Program)

Experience : 8 - 12 Years

Location : Mumbai

Job Mode :

Hybrid ( 3 days at least )

NOTE : Please look for Healthcare/ Insurance domain

Role Overview :

The Health & Insurance Domain Practice Business Analyst is a business centric domain expert responsible for shaping and validating requirements for enterprise Data, Reporting & AI (DRA) program. The role ensures that health insurance business processes, regulatory obligations, and operational insights are correctly translated into reporting, data products, APIs, and AI use cases.

This role s primary focus is domain depth, regulatory understanding, and stakeholder alignment with SQL knowledge.

Key Responsibilities :

Health Insurance Domain Leadership :

Act as the domain SME for Standalone Health Insurance, covering :

- Policy lifecycle (issuance, endorsements, renewals, cancellations)

- Claims (cashless, reimbursement, adjudication, TATs, leakages)

- Sales & distribution (agents, FLS, branch/region hierarchies)

- Customer, product, provider, renewal, and cross's ell processes

- Ensure requirements reflect business terminology and operating reality.

Regulatory & Statutory Reporting :

- Own business requirements for IRDAI, BAP, public disclosure, and statutory reports.

- Define business rules, validations, reconciliations, and approval workflows.

- Specify pixel perfect output expectations (Excel/PDF) from a compliance perspective.

Reporting & Self Service Analytics (Business View) :

- Define KPIs, metrics, hierarchies, drill downs, and filters for operational, regulatory, and sales reports.

- Maintain and prioritize the report inventory based on business value.

- Define self service reporting needs (user access, usability, governance).

Data Products, APIs & AI (Functional Focus) :

- Define business use cases for data products and APIs (who consumes, why, expected

outcomes).

- Shape AI / conversational reporting use cases - business questions, guardrails, and acceptance criteria.

- Validate that outputs support decision making, not technical elegance.

Governance, Quality & Compliance (Business Lens) :

- Define Critical Data Elements (CDEs), business rules, and quality expectations.

- Ensure requirements incorporate privacy, auditability, and regulatory controls.

- Support governance forums with business impact assessments.

Agile Delivery & Stakeholder Management :

- Lead business workshops and backlog grooming.

- Translate needs into clear user stories and acceptance criteria.

- Own UAT coordination from the business side - scenarios, validation, defect prioritization, and sign off.

- Manage scope changes with clear business justification.

Key Deliverables :

- Domain requirement packs (Policy, Claims, Sales, Customer, Renewal)

- Regulatory reporting requirements and validation rules

- Report inventory with KPI definitions

- Data product / API functional use cases

- AI / conversational reporting use cases

- UAT scenarios and business sign off artefacts

Skills & Experience :

Must Have :

- 8 - 12+ years as a Business Analyst in Health / Insurance domain

- Strong understanding of Standalone Health Insurance operations

- Hands on experience with regulatory/statutory reporting

- Excellent stakeholder communication and documentation skills

Nice to Have :

- Conceptual understanding of reporting and analytics

- Experience working with large transformation or analytics programs