Project Role : Business Architect
Project Role Description : Identify opportunities to deliver tangible business value by assessing the current state, capturing high-level requirements, and defining business solutions. Translate business needs into technology-enabled solutions and operating models. Support transformation by developing business cases and guiding implementation of key initiatives.
Must have skills : Medicare Advantage
Good to have skills : Health Insurance Operations, Electronic Medical Records (EMR)
Minimum 5 year(s) of experience is required
Educational Qualification : 15 years full time education

Summary: As a Configuration Lead, you will identify opportunities to deliver tangible business value by assessing the current state, capturing high-level requirements, and defining business solutions in healthrules. Your typical day will involve collaborating with various stakeholders to understand their needs, analyzing existing processes, and proposing innovative solutions that align with the organization's strategic goals. You will also engage in discussions to translate business requirements into actionable technology-enabled solutions, ensuring that the initiatives you support are effectively implemented and deliver the desired outcomes. Roles & Responsibilities: -Lead the configuration of Pricing Team in HealthRules Payor. -Analyze business requirements and convert them into HRP configuration logic. -Configure fee schedules, provider contracts, pricing rules, and modifiers. -Collaborate with Product Owners, QA, and business teams throughout the SDLC. -Support UAT, testing, and post-production issue resolution. -Maintain configuration documentation and ensure regulatory compliance (e.g., CMS). -Mentor junior team members and help maintain best practices in configuration governance. Professional & Technical Skills: -4-6 years of HRP configuration experience. -Strong knowledge of payer pricing models (e.g., CMS, APC, DRG, RBRVS). -Experience with claims processing, 837/835 formats, and SQL/Excel for validation. -Strong analytical, documentation, and stakeholder communication skills. Additional Information: - The candidate should have minimum 7.5 years of experience in Medicare Advantage. - This position is based at our Chennai office. - A 15 years full time education is required.

15 years full time education

About Accenture

Accenture is a leading global professional services company that helps the world’s leading businesses, governments and other organizations build their digital core, optimize their operations, accelerate revenue growth and enhance citizen services—creating tangible value at speed and scale. We are a talent- and innovation-led company with approximately 791,000 people serving clients in more than 120 countries. Technology is at the core of change today, and we are one of the world’s leaders in helping drive that change, with strong ecosystem relationships. We combine our strength in technology and leadership in cloud, data and AI with unmatched industry experience, functional expertise and global delivery capability. Our broad range of services, solutions and assets across Strategy & Consulting, Technology, Operations, Industry X and Song, together with our culture of shared success and commitment to creating 360° value, enable us to help our clients reinvent and build trusted, lasting relationships. We measure our success by the 360° value we create for our clients, each other, our shareholders, partners and communities.

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