Our client, a US Fortune 50 organization and a leading provider of Health care and Health Insurance services, seeks an accomplished IBM Case Manager Business Analyst.
______________________________________________________________________
NOTE: THIS IS REMOTE ROLE & ONLY W2 CANDIDATES (NO C2C/1099).
*** Candidate must be authorized to work in USA without requiring sponsorship ***
Position: IBM Case Manager Business Analyst (Job Id: WLPTJP00047066)
Location: Baltimore MD (REMOTE)
Duration: 12 Months + Possible Extension
______________________________________________________________
Position Summary:
Seeking an experienced systems analyst to assess applications, integrations, automation, and workflows impacted by the Medicare claims migration to ClaimsCore. Collaborates with business and technical stakeholders to define clear, testable future-state requirements.
Key Responsibilities:
- Lead current-state analysis of Medicare Part A/B IBM Case Manager (ICM) applications, workflows, business processes, interfaces, and dependencies.
- Document integrations, data exchanges, processing triggers, operational controls, exceptions, and upstream/downstream dependencies with claims processing systems.
- Assess existing functionality against ClaimsCore requirements; identify application, workflow, data, and integration gaps and impacts.
- Facilitate stakeholder workshops to validate business outcomes, processes, system interactions, and requirements.
- Collaborate with technical teams to evaluate ClaimsCore native capabilities and APIs; recommend whether existing integrations should be retained, modified, replaced, or retired.
- Develop business/functional requirements, user stories, process maps, interface and data specifications, acceptance criteria, and traceability to impacted applications and work packages.
- Partner with architects on future-state workflows, API integrations, and modernization opportunities.
- Identify Jurisdiction K and Jurisdiction 6 needs, including configurations, business rules, data, and testing.
- Coordinate with Wellpoint Federal teams and, when authorized, CMS and the ClaimsCore vendor to resolve functional and technical questions.
- Partner with QA on functional, integration, negative, regression, and legacy/ClaimsCore coexistence testing.
- Maintain analysis artifacts, decisions, dependencies, and work items in approved Agile tools, including JIRA; support knowledge transfer and implementation readiness.
Required Qualifications:
- Senior systems/business systems analysis experience with IBM Case Manager (ICM) or IBM Business Automation Workflow (BAW), including architecture, workflows, rules, and integrations.
- Experience in current-state discovery, process mapping, gap/impact analysis, and application modernization or migration.
- Ability to analyze APIs, interfaces, data exchanges, batch processes, operational workflows, and system dependencies.
- Proficiency creating functional/technical requirements, user stories, acceptance criteria, process flows, interface specifications, data mappings, and requirements traceability.
- Strong analytical, problem-solving, documentation, communication, and cross-functional collaboration skills, including work with incomplete legacy specifications.
- Experience with Agile delivery, JIRA, testing, and technical stakeholder coordination.
Preferred Qualifications:
- Experience with IBM FileNet P8, IBM Content Navigator, or BAW.
- Knowledge of healthcare claims processing, payer operations, and adjudication, preferably Medicare Part A/B.
- Experience with legacy migrations, enterprise integrations, platform coexistence, and data reconciliation.
- Familiarity with SQL, XML, JSON, and REST/SOAP services.
_______________________________________________________
If you're looking for rewarding employment and a company that puts its employees first, we'd like to work with you. We're driven, people driven
Bhupesh Khurana
Senior Technical Recruiter
Email:
Amerit Consulting is an extremely fast-growing staffing and consulting firm. Amerit Consulting was founded in 2002 to provide consulting, temporary staffing, direct hire, and payrolling services to Fortune 500 companies nationally; as well as small to mid-sized organizations on a local & regional level. Currently, Amerit has over 2,000 employees in 47 states. We develop and implement solutions that help our clients operate more efficiently, deliver greater customer satisfaction, and see a positive impact on their bottom line. We create value by bringing together the right people to achieve results. Our clients and employees say they choose to work with Amerit because of how we work with them - with service that exceeds their expectations and a personal commitment to their success. Our deep expertise in human capital management has fueled our expansion into direct hire placements, temporary staffing, contract placements, and additional staffing and consulting services that propel our clients’ businesses forward.
Amerit Consulting provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
