Summary
Overview
Work History
Education
Skills
Timeline
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Madhu Krishna Patlolla

Hyderabad

Summary

Accomplished Business Analyst with over 12 years of experience in healthcare domain, including 4 years in US Healthcare IT. Demonstrated expertise in payer operations, enrollment, and QNXT. Strong foundation in business requirements gathering, EDI transactions (834, 837, 835), process improvement, and stakeholder management. Proficient in collaborating with cross-functional teams to deliver scalable, compliant, and cost-effective healthcare technology solutions. Expert in aligning business and technical requirements to ensure high-quality solution delivery that meets business objectives.

Overview

13
13
years of professional experience

Work History

Senior Consultant (Business Analyst, US Healthcare)

Infosys Ltd
07.2021 - Current
  • Managed EDI 834 file processing for eligibility and enrollment updates in QNXT.
  • Oversaw PCP assignment, ID card processing, and eligibility extracts for vendors.
  • Conducted requirements gathering, JRP/JAD sessions, authored BRDs/FRDs.
  • Validated TDDs, led UAT/SIT walkthroughs, coordinated with IT for production fixes.
  • Achievements: Reduced enrollment file errors by 15% and reduced Access to care issues improving the Client compliance with regulatory guidelines.

Deputy Manager

Health Insurance TPA of India Ltd
04.2016 - 07.2021
  • Managed provider relations, onboarding, audits, and tariff negotiations.
  • Partnered with claims, enrollment, pre-authorization, and payments teams to resolve provider/member issues.
  • Achievements: Negotiated tariffs saving 10–12% for payers and improved grievance resolution efficiency by 25%.

Associate Provider Manager

Reliance General Insurance
12.2015 - 04.2016
  • Expanded provider network, conducted tariff analysis, audits, and fraud investigations.
  • Enhanced cashless hospitalization processes in collaboration with hospital partners.

Team Member, Networks

United Healthcare
07.2013 - 12.2015
  • Handled hospital empanelment, tariff restructuring, and wellness program rollouts.
  • Ensured seamless cashless hospitalization and resolved provider escalations.

Executive, Administration

Global Hospitals
05.2012 - 07.2013
  • Streamlined admission and discharge turnaround times and coordinated patient care across OPD, ICU, and OT.

Education

MBA - Healthcare & Hospital Management

University of Hyderabad
Hyderabad
04-2012

B.Sc - Nursing

NTR University of Health Sciences
01.2009

Skills

  • Business requirements analysis, requirements elicitation
  • BRD/FRD documentation
  • Test case scenarios User acceptance testing
  • Stakeholder engagement
  • SQL MS Visio
  • Team collaboration
  • Project management
  • Strong leadership skills
  • Client relationship management
  • Data-driven decision making
  • Cross-functional collaboration
  • Change management
  • Data analytics
  • EDI processing
  • Attention to detail Problem solving
  • Industry knowledge
  • Gap analysis
  • Clear communication
  • Change impact analysis
  • Agile methodologies

Timeline

Senior Consultant (Business Analyst, US Healthcare)

Infosys Ltd
07.2021 - Current

Deputy Manager

Health Insurance TPA of India Ltd
04.2016 - 07.2021

Associate Provider Manager

Reliance General Insurance
12.2015 - 04.2016

Team Member, Networks

United Healthcare
07.2013 - 12.2015

Executive, Administration

Global Hospitals
05.2012 - 07.2013

MBA - Healthcare & Hospital Management

University of Hyderabad

B.Sc - Nursing

NTR University of Health Sciences

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