Overview
Skills
Job Details
Expert Business Analyst Medicaid Managed Care Contract Compliance Tracking
Position Summary
DHHS Information Systems and Technology (IS&T) is seeking a skilled Expert Business Analyst to lead the implementation and ongoing support of a Contract Compliance Tracking System. This role is central to ensuring compliance with federal and state Medicaid managed care oversight requirements through effective system design, stakeholder engagement, issue resolution, and continuous improvement. The ideal candidate will bring deep domain knowledge of Medicaid Managed Care, strong analytical and documentation skills, and a proactive approach to process improvement and stakeholder collaboration.
Key Responsibilities
Lead business analysis activities for the design, implementation, and maintenance of the Medicaid Contract Compliance Tracking system
Develop and manage system requirements, workflows, business rules, and process documentation
Perform extensive data validation and data mapping.
Create and execute comprehensive test cases for UAT, system integration, and regression testing
Engage with internal stakeholders and end users to support user testing, feedback collection, and training
Serve as a liaison between business units, technical teams, and MCOs to ensure requirements are clearly understood and delivered
Develop, track, and maintain project deliverables including requirements documents, process flows, use cases, test plans, and user manuals
Oversee dashboarding and reporting features to track compliance metrics, corrective action plans, and key performance indicators
Monitor and manage production support issues, facilitate triage, and ensure timely resolution
Identify and implement opportunities to improve compliance workflows and tracking mechanisms
Support issue management processes, including documentation, prioritization, root cause analysis, and resolution tracking
Required Credentials and Experience
Minimum 5 years of experience as a Business Analyst, with at least 3 years focused on Medicaid Managed Care or other state/federal health programs
Strong knowledge of Medicaid Managed Care programs, federal regulations (e.g., CFR 42 MCO oversight/compliance processes
Demonstrated experience gathering business requirements, creating process flows, and documenting business rules
Hands-on experience with test case development and execution
Proven ability to engage end users and facilitate UAT and production support
Excellent communication skills, both written and verbal
Proficiency with tools such as JIRA, Confluence, Visio, Excel, and report/dashboard platforms (e.g., Power BI or Tableau)
Preferred Credentials and Experience
Bachelor s degree in Business, Health Administration, Information Systems, Public Policy, or related field
Prior experience implementing or supporting compliance or case tracking systems in a state Medicaid agency
Familiarity with Medicaid Enterprise Systems (MES), CMS reporting requirements, and audit readiness practices
Experience with workflow automation and dashboard/reporting design
Knowledge of Agile/Scrum methodology and tools
Experience coordinating across business, IT, and policy teams in a government environment