Key Tasks and Responsibilities
Business and Systems Analysis
- Collaborate with underwriting, claims, finance, and distribution teams to gather, document, and analyze business requirements.
- Develop functional and technical specifications based on operational needs across the health insurance lifecycle.
- Map existing business processes to system functionality, identifying areas for automation or improvement.
- Contribute to product backlog development, sprint planning, and release roadmaps in coordination with the IT BRM and business leads.
Application Support and Maintenance
- Provide Level 1/2 support while working closely with Level 3 support team/s for core health insurance platforms such as policy administration systems, claims management tools, intermediaries’ portals, and regulatory reporting engines.
- Troubleshoot system errors, data inconsistencies, and performance issues, ensuring timely resolution with minimal business disruption.
- Monitor application logs, perform root cause analysis, and liaise with third-party vendors or infrastructure teams for resolution.
- Ensure data integrity across systems, including policy, claims, reinsurance, and finance modules.
- Troubleshoot issues affecting core system processes, and integrations interfacing with the core policy administration system (e.g., SMART 3rd party EDI & Biometric platform, D365 FO ERP, CRM 365, SharePoint, regulator platforms).
Software Development and Integration
- Design, develop, and maintain custom application features, scripts, reports, and interfaces that support health insurance operations.
- Implement configuration changes, system enhancements, and integrations (e.g., with banks, regulators, intermediaries, and service providers).
- Build APIs and microservices for cross-platform data exchange and automation, ensuring secure and scalable solutions.
- Work with DevOps teams to support CI/CD processes, version control, and deployment to test and production environments.
Testing and Quality Assurance
- Develop and execute test plans and cases for new features, bug fixes, and system integrations.
- Support user acceptance testing (UAT), coordinate defect triaging, and ensure issues are resolved ahead of production releases.
- Ensure adherence to regulatory compliance and internal control standards (e.g., IRA, IFRS 17, GDPR, or other applicable frameworks).
Documentation, Training and Reporting
- Maintain system documentation including architecture diagrams, process flows, and support playbooks.
- Document known issues and solutions to aid knowledge transfer and faster incident resolution.
- Provide training and technical guidance to end-users, super-users, and junior IT staff.
- Develop and maintain internal knowledge base articles for known errors, fixes, and workarounds on service delivery platform i.e., Service Now (SNOW).
Continuous Improvement
- Stay up to date with technological trends in health insurance, healthcare, and proactively propose improvements.
- Integrate digital innovations (e.g., chatbots, self-service portals, mobile apps) to improve customer and agent experiences.
- Assess and recommend solutions or tools from service providers that could enhance business efficiency or customer engagement.
Qualifications
- Bachelor’s degree in computer science, Information Systems, or related field
- 3–6 years of experience in a hybrid role involving analysis, development, and support in the insurance or financial services industry
- Experience with health insurance systems such as underwriting, policy administration, claims processing, or regulatory reporting platforms
- Technical certifications in software development, business analysis, or ITIL are an added advantage
- Experience with integration tools (e.g., middleware, REST APIs, message queues) and cloud-based services is desirable.
Skills and Competences
- Deep understanding of Health insurance operations: underwriting, claims, intermediaries, billing, and compliance
- Proficient in systems analysis, problem-solving, and application support
- Hands-on experience in software development (e.g., .NET, Java, SQL, APIs)
- Solid understanding of application architecture, versioning, and automated testing
- Strong communication and stakeholder engagement skills