Job Description :
Hi,
Please find my direct client requirement for your consideration.
Title: Sr. Business Analyst (Medicaid)
Location: Columbia SC
Duration: 12 Months
Job Description
Daily Duties / Responsibilities:
The Provider Services Business Analyst (BA) is responsible for evaluating agency needs, as-is and to-be business processes, and technical designs to provide analysis and advice on strategies for information technology solutions and non-technical solutions. Most of the system development work will be outsourced to vendors and other State organizations.
Duties include:
Requirements development execution, including the elicitation, analysis, specification and validation;
Modeling Provider enrollment and payment business processes (As-Is and To-Be) through sequence
diagrams, business process models, etc.;
Documenting and analyzing agency business processes and recommending improvements;
Documenting and analyzing provider enrollment and financial requirements and relationships;
Participate in the requirements management processes, including change control; version control; tracking
and status reporting; and traceability;
Providing requirement interpretation and guidance to technical and test teams;
Proactively identifying risks, issues, and action items leading to possible solutions;
Interacting with internal and external organizations (i.e. vendors, State and Federal government agencies,
State providers and beneficiaries, and other stakeholders
Planning for, conducting, and reporting on testing and other quality assurance activities;
Other related activities.
Subject matter requirements include:
Medicaid or Medicare provider enrollment and management;
Claims processing and payment;
State budget assignments;
Financial management;
Provider reimbursement methodology
Required Skills (Rank In Order Of Importance):
Desired 6 years of experience in Provider Enrollment and Management, Claims Payment and Financial
systems, but manager would look at someone with less. The more the better
4 years of experience with Medicaid budget assignments and financial general ledger reporting
3 years of experience in healthcare insurance business operations (payer or provider side; government or
commercial side) with a focus on provider enrollment and provider reimbursement
3 years of experience in Financial Management
Preferred Skills (Rank In Order Of Importance):
Understanding of the Medicaid Information Technology Architecture (MITA)
Provider outreach and education
Agile project methodology
Required Education:
Bachelor’s degree.
Skills
Category
Name
Required
Importance
Level
Last Used
Experience
Administrative
Verbal Communication Skills
Yes
1
Lead
Currently Using
6 + Years
Administrative
Written Communication Skills
Yes
1
Lead
Currently Using
6 + Years
Education
BA Degree- Technical, Business, or Healthcare field
Yes
1
Lead
Within 10 Years
4 - 6 Years
Financial
Claims Payment and Financial systems
Yes
1
Lead
Currently Using
2 - 4 Years
MMIS - Medicaid Management Informaiton System
Healthcare Insurance - Business Operations
Yes
1
Lead
Currently Using
2 - 4 Years
MMIS - Medicaid Management Informaiton System
Experience with the Medicaid Information Technology Architecture (MITA) principles and framework
No
1
Intermediate
Within 2 Years
1 - 2 Years
Program Management
financial management
Yes
1
Lead
Currently Using
2 - 4 Years
Program Management
Agile/Scrum Methodology
No
1
Intermediate
Within 2 Years
1 - 2 Years
If Interested please provide me below information:
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