Director - Capability (Healthcare)

Company Description

WNS (Holdings) Limited (NYSE: WNS), is a leading Business Process Management (BPM) company. We combine our deep industry knowledge with technology and analytics expertise to co-create innovative, digital-led transformational solutions with clients across 10 industries. We enable businesses in Travel, Insurance, Banking and Financial Services, Manufacturing, Retail and Consumer Packaged

Goods, Shipping and Logistics, Healthcare, and Utilities to re-imagine their digital future and transform their outcomes with operational excellence. We deliver an entire spectrum of BPM services in finance and accounting, procurement, customer interaction services and human resources leveraging collaborative models that are tailored to address the unique business challenges of each client. We co-create and execute the future vision of 400+ clients with the help of our 44,000+ employees.

Job Description

Key Responsibilities:Business Analysis & Requirements Gathering

• Engage with RCM stakeholders (operations, compliance, technology) to gather and document detailed business requirements across intake, coding, billing, claims, A/R, and denials.
• Define user stories, business rules, data flows, and system behavior aligned with operational outcomes.
• Work closely with product managers to prioritize features based on business value and technical feasibility.

Subject Matter Expertise (SME)

• Provide domain expertise in U.S. healthcare revenue cycle processes and technologies.
• Offer field-level insights from front-end intake through back-end collections and appeals.
• Advise on industry best practices, compliance considerations, and emerging trends in automation and AI adoption in RCM.Techno-Functional Collaboration
• Act as a liaison between business users and development teams to ensure solution design aligns with functional needs.
• Partner with architects and engineers on data modeling, workflow engines, and AI/ML model integration.
• Participate in user acceptance testing (UAT), validating system outputs against business expectations.

Platform Innovation

• Contribute to platform design and modularization of features such as (but not limited to):o Claims Automation (e.g., OCR, NLP, intelligent form capture)o Autonomous Coding (ICD/CPT code prediction using AI/ML)o Process Optimization (clearinghouse logic, eligibility validation)o Denials Prevention & Prediction (ML-based denial scoring, root cause analytics)
• Identify opportunities for AI/automation to enhance accuracy, reduce TAT, and minimize human intervention.

Documentation & Change Management

• Develop clear documentation including BRDs, FRDs, process maps, and data dictionaries.
• Support training, change management, and knowledge transfer to internal teams and client stakeholders.

Qualifications

Qualifications:

• Bachelor's degree in Healthcare Administration, Information Systems, Computer Science, or related field.
• 10+ years of experience in RCM operations, product development, or business analysis, preferably in a healthcare technology or BPO setting.
• Deep understanding of end-to-end RCM workflows and pain points.
• Experience working with or designing solutions involving automation, RPA, AI/ML, and data analytics.
• Familiarity with RCM platforms, EHRs (e.g., Epic, Cerner, Athena), and clearinghouse integrations.________________________________________Preferred Skills:
• Experience with product development lifecycles (Agile, Scrum).
• Experience in working with wide range of practice management systems used by providers in the US
• Data sourcing and integration experience with leading EHR/EMR, clearing houses and payer claims systems
• Proficiency in tools such as JIRA, Confluence, Lucidchart/Visio, SQL.
• Exposure to technologies like OCR, NLP, RPA (UiPath, Automation

Anywhere), and machine learning models.

• Certifications in Business Analysis (CBAP/CCBA), Healthcare IT (e.g., CPHIMS), or Lean/Six Sigma.