Job Description :
What is the specific title of the position
* Business Analyst - Medicaid LTSS Program Development
What Project/Projects will the candidate be working on while on assignment
* Medicaid LTSS Programs - Prior Authorization Management to start. As a Business analyst you will be required to elicit requirements for various types of Prior Authorizations submitted by Providers in the Client of Massachusetts. These Prior Authorization processes should be as stream-lined as possible to enable fast approvals with quality review and application of medical necessity. You will also assist with the solutioning of the requirements which for us is the creation of wire frames for a provider portal where this PA data is submitted. You will also be involved with the testing of this new solution to make sure the UAT process is smooth and issues/changes/defects are minimized.
IDEAL BACKGROUND: Healthcare, Medicaid experience, Prior Authorization experience, Care coordination/Care Delivery experience, Salesforce experience.
TOP REQUIREMENTS:
Communication : Good written and verbal communication.
Visualizations : flow charts or other diagrams/wireframe
Organization: this is a fast paced environment.
* What experience will set candidates apart from one another Healthcare, Medicaid experience, Prior Authorization experience.
* Methodology : small waterfall, looking to be more Agile in near future.
Team Size:
- Broader team is ~18
- PA BA team size was at 5, some staff transitioning to new roles.
- Dev team is at 6
- M&O team is in place and will assume larger M&O role moving forward that will allow BA''s to focus more on DDI work.
Team structure:
- Team is broken into work streams.
- Prior Authorization/Utilization Management is one of those work streams, that would be their first focus.
- Additional work streams are;
o Provider Enrollment, revalidation, training. (PERT)
o Program Integrity
o Electronic Visit Verification
o Uniform Common Assessment
o Quality, Reporting and Analytics
Interaction with:
- Optum Clinical team members
- Optum Prior Authorization staff.
- Client clinical team members
What are the top 5-10 responsibilities for this position (Please be detailed as to what the candidate is expected to do or complete on a daily basis)
* gather requirements
* define process flow
* define solution
* test solution.
What software tools/skills are needed to perform these daily responsibilities
* Visio/Word/Excel/SalesForce
What skills/attributes are a must have
* Requirement gathering.
* Process flow / process design experience
* Testing experience
What skills/attributes are nice to have
* UI design experience (most have established patterns)
* Medicaid knowledge
* Prior Authorization knowledge/experience
Where is the work to be performed (Please list preferred Client facility, if other please specify i.e. remote work, rural, etc
* Optum Campus - MN102
What are the work hours (ex. 9am-5pm, day/night shifts, rotating shifts, etc)
* 8-5 Mon-Fri. Some weekend work possible during implementation/go-live.
What type of interview process is preferred (Face to face, phone, Skype, or a combination of the three)
* Hireview if possible, face to face alternatively.