Business Analyst

Health Insurance Domain Practice Business Analyst

( Data, Reporting \& AI Program)

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‑sell 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

Success Measures

• Clarity and completeness of business requirements
• On‑time UAT sign‑offs with minimal business defects
• Audit acceptance of regulatory reports
• Business adoption and satisfaction with reporting and AI outcomes