Healthcare Business/Quality Analyst (Inperson Interview)

Short Description:

Systems Analyst 4 (Inperson Interview)

Complete Description:

ABOUT THE ROLE:

Systems Analyst 4/Testing

We are seeking a highly skilled Systems Analyst with strong technical and analytical expertise in healthcare claims processing and comprehensive knowledge of data across all functional areas of the Medicaid Management Information System (MMIS) or a similar large-scale claims processing system.

Key Responsibilities:

• Conduct impact analysis for system changes, enhancements, and new module implementations within MMIS/MES.
• Lead advanced analysis across FAS Member, Claims, and Finance modules; assess business objectives, evaluate system impacts, and define highlevel solution approaches.
• Evaluate FAS workflows, identify system gaps, and recommend strategic enhancements to improve automation, accuracy, and compliance.
• Oversee system development activities, including design reviews, integration testing, defect resolution, and production validation.
• Serve as a senior technical liaison with vendors, fiscal agents, and crossfunctional teams to ensure stable, compliant FAS operations.
• Support FAS upgrades, interface enhancements, configuration changes, and system security improvements.
• Coordinate crossmodule alignment to ensure changes in Member, Claims, or Finance workflows do not create downstream system conflicts.
• Support audit and compliance activities by providing expert insights into FAS processes, data structures, and financial reconciliation workflows.
• Drive root cause analysis for complex production issues affecting FAS Member, Claims, and Finance modules, and coordinate longterm corrective actions.
• Develop and execute comprehensive Test Strategies, including System Integration Testing (SIT), User Acceptance Testing (UAT), and EndtoEnd (E2E) testing for MMIS and MES modules.
• Perform Agile testing activities, including participating in sprint planning and backlog refinement, designing test cases with development teams, validating user stories, and executing continuous integration testing within each sprint.
• Test Commercial OfftheShelf (COTS) applications and support data conversion and integration across MES modules and COTS products.
• Create and support development of Business Test Scenarios, Test Cases, and Test Data; assist with test execution activities.
• Support ongoing system releases, enhancements, and production defect resolution.
• Lead and manage defect triage calls with multiple vendors, ensuring accurate defect tracking and timely closure.
• Communicate UAT progress, results, and metrics to stakeholders; maintain comprehensive historical testing documentation.
• Monitor schedules, track execution progress, and communicate risks and issues promptly.
• Collaborate effectively with technical teams, business users, and crossfunctional groups with minimal supervision.

Required Skills and Experience:

• Healthcare Claims Expertise: Indepth knowledge of MMIS or similar largescale claims processing systems.
• Testing Leadership: Ability to coordinate and direct all testing phases in a multivendor environment.
• Proven Agile Testing experience, including planning and executing functional, integration, and regression testing within iterative sprint cycles.

Technical Skills:

• Proficiency in Teradata, including writing complex queries.
• Experience with Mainframe and DB2 testing preferred.
• Strong experience in data conversion, mapping rules, validation, ETL design, and programming logic.
• Experience with IBM Cognos or similar reporting tools is preferred.
• Test Management Tools: Extensive experience with Azure DevOps or comparable tools for planning, tracking, and executing test activities.
• Defect Management: Strong experience managing UAT and defect triage calls across multiple systems and vendors.
• ProblemSolving: Strong debugging skills and ability to act as a liaison between developers and business users.
• Excellent organizational and communication skills; ability to meet deadlines with professionalism and customer focus.

Skill Matrix: