Medicaid Pricer Regulatory Analyst

About the role

Zelis is modernizing the healthcare financial experience in the United States (U.S.) across payers, providers, and healthcare consumers. We serve more than 750 payers, including the top five national health plans, regional health plans, TPAs and millions of healthcare providers and consumers across our platform of solutions. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts - driving real, measurable results for clients. At Zelis, AI is woven into the fabric of how we work. Every associate is expected - and empowered - to partner with AI to challenge the status quo, accelerate innovation, and amplify their impact. This is a place for builders with a growth mindset who act with agility, embrace change, and use modern technology to shape smarter solutions, exceptional experiences, and the future of our industry for our clients, customers, and our culture. Why We Do What We Do In the U.S., consumers, payers, and providers face significant challenges throughout the healthcare financial journey. Zelis helps streamline the process by offering solutions that improve transparency, efficiency, and communication among all parties involved. By addressing the obstacles that patients face in accessing care, navigating the intricacies of insurance claims, and the logistical challenges healthcare providers encounter with processing payments, Zelis aims to create a more seamless and effective healthcare financial system. Zelis India plays a crucial role in this mission by supporting various initiatives that enhance the healthcare financial experience. The local team contributes to the development and implementation of innovative solutions, ensuring that technology and processes are optimized for efficiency and effectiveness. Beyond operational expertise, Zelis India cultivates a collaborative work culture, leadership development, and global exposure, creating a dynamic environment for professional growth. With hybrid work flexibility, comprehensive healthcare benefits, financial wellness programs, and cultural celebrations, we foster a holistic workplace experience. Additionally, the team plays a vital role in maintaining high standards of service delivery and contributes to Zelis' award-winning culture. Position Overview The Medicaid Regulatory Pricer Analyst is an entry-level role within the Zelis Regulatory Pricer Product team. This position supports senior analysts by performing foundational research, executing routine data updates, and assisting with documentation and quality assurance activities. The analyst will begin building subject-matter expertise in Medicaid reimbursement as well as institutional and professional payment methodologies. This role is ideal for individuals early in their healthcare, regulatory, or data analysis career who are eager to learn complex reimbursement concepts and contribute to accurate and compliant pricing system operations. Essential Duties & Responsibilities - Regulatory Research & Support - Perform basic research on Medicaid regulations, state bulletins, and published fee schedules under the guidance of senior team members. - Summarize regulatory findings and assist in interpreting requirements for internal use. - Pricing Updates & Documentation - Assist in maintaining pricing logic and configuration by performing routine updates and data entry tasks. - Help draft or update procedural documentation, SOPs, and reference materials. - Contribute to the creation of user story components (e.g., requirements outlines, rule summaries). - Data Analysis, Validation, Quality Assurance & Testing - Use Excel or internal tools to conduct comparisons, calculations, and data-driven validation. - Support the preparation of sample claims and expected outcomes for testing and QA. - Participate in system testing by executing test cases and documenting results. - Assist in identifying potential issues or discrepancies in pricing outputs and escalating to senior analysts. - Cross-Team Communication & Support - Collaborate with internal teams-including Development, QA, and Client Services-to clarify questions and support project work. - Provide general operational support to senior analysts on assigned Medicaid payment systems. - Other Responsibilities - Perform additional duties as assigned to support team and organizational goals.