Job Title: Computer Systems Analysts
Location: Espanola, NM
Employer: 4Consulting, Inc
Position Type: Full Time
Worksite: Remote
Position Summary
4Consulting, Inc is seeking a qualified Computer Systems Analysts to support technology consulting, application development, systems analysis, testing, data management, cybersecurity, infrastructure, or project delivery services for client projects. The selected candidate will perform duties consistent with the client’s project requirements and company delivery standards.
Essential Duties and Responsibilities
The candidate will be responsible for:
- Lead claims domain analysis for MMIS projects, including requirements analysis, claims lifecycle processes, business rules, and implementation decisions.
- Analyze and document claims requirements, workflows, interfaces, benefit configurations, data requirements, and system functionality while supporting solution design.
- Collaborate with clients, development, architecture, QA, and business teams to resolve issues, conduct demonstrations, validate requirements, and manage stakeholder feedback.
- Perform system and data analysis, support root-cause analysis, review test scenarios and traceability, and provide guidance throughout implementation and product delivery.
Minimum Qualifications
The position requires:
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Education
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Bachelor’s degree in Computer Science, Information Technology, Engineering, Business, or related field, or equivalent combination of education and experience.
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Experience
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8+ years of experience in business analysis and healthcare technology, including MMIS, Medicaid/Medicare, claims processing, claims adjudication, and healthcare systems.
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Technical Skills
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SQL, EDI X12, Interface Testing, Postman, Data Validation, Requirements Analysis, Requirements Traceability, Test Scenario Validation, Root Cause Analysis, System Analysis
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Business / Domain Skills
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- Experience supporting Medicaid and Medicare healthcare programs within MMIS environments, including complex claims administration, member and provider processes, benefits, encounters, capitation, and healthcare financial operations.
- Experience analyzing healthcare claims lifecycle processes, including member/provider management, professional, institutional, dental, pharmacy, and encounter claims, adjudication, payment cycles, and claims reporting.
- Experience supporting MMIS claims processing and adjudication, including benefit and program configuration, reference data, claims business rules, EDI transactions, payment processing, and integration across claims-related subsystems.
- Experience analyzing healthcare claims data and business requirements, performing root-cause analysis, validating system functionality, coordinating with clients and development teams, and translating Medicaid regulatory and operational requirements into implementation solutions.
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Communication
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Ability to communicate with technical and business stakeholders.
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Documentation
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Ability to prepare project documentation, status updates, and deliverables.
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Work Authorization
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Must be legally authorized to work in the United States. Sponsorship may be considered where permitted by company policy and project requirements.
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Certification Required
None
Travel Required
None
Supervisory Role
No
Preferred Qualifications
- Experience with MMIS claims systems, benefits configuration, reference data, payer processes, and claims-related subsystems.
- Experience working with clients, business users, development, architecture, QA, and technical teams across requirements, implementation, testing, and production support.
- Bachelor’s degree in a relevant field preferred, with strong communication, analytical, problem-solving, and stakeholder management skills.
Equal Employment Opportunity Statement
4Consulting, Inc is an Equal Opportunity Employer. Employment decisions are made without regard to race, color, religion, sex, national origin, age, disability, veteran status, citizenship status, immigration status where protected by law, or any other legally protected status. All candidates will be evaluated based on job-related qualifications, experience, skills, availability, and ability to perform the essential duties of the position.
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