Medicaid Business Analyst

Medicaid Business Analyst

Location: Columbia, SC

Duration: 12+ months

Experience Required

• Possess expertise in the business unit(s) they support, as well as an understanding of the IT organization's systems and capabilities
• Analyze business partner's operations to understand their strengths and weaknesses to determine opportunities to automate processes and functions
• Assist in the business process redesign and documentation as needed for new technology
• Translate high level business requirements into functional specifications for the IT organization and manage changes to such specifications
• Educate the IT organization on the direction of the business
• Negotiate agreements and commitments by facilitating communication between business unit(s) and IT from initial requirements to final implementation
• Possess an understanding of technological trends and use this knowledge to bring solutions to business units supported to enhance the enterprise's competitive edge

Responsibilities

• Perform business process analysis and performance assessments for the assigned projects
• Train and mentor team members in delivering high quality business solutions that meet the overall strategy and vision
• Build positive relationships with clients and proactively address specific needs
• Lead business design sessions within assigned modules and work streams
• Advocate and lead business integration in support of the MES Modernization
• Drive, though dynamic discussion, efficient configuration of data within the core modules of MES Modernization
• Provide liaison role between business and IT verticals
• Ensure project deliverables for each project connect to the operational principles
• Coordinate priorities and resources between multiple projects.
• Provide updates on status and issues for all assignments
• Participate in scheduled operational meetings and routine team leads meetings
• Lead cross-functional meetings and produce business designs that integrate functionality across modules
• Facilitate sessions to effectively resolve issues if any
• Provide recommendations of appropriate resources if necessary to ensure assignments are completed within given time and budget
• Create and maintain key performance indicators to indicate project progress toward business integration goals

Skills Needed

• 7 years of experience in commercial healthcare
• 6 years of experience eliciting, mining, and documenting business rules/processes
• 3 years of experience in State Medicaid payer system integration and delivery
• 3 years of experience with inner workings of cross functional projects
• 3 years familiarity with Medicaid Information Technology Architecture (MITA) business architecture principles
• 3 years familiarity with standard data structures, electronic data interchange, processes and related file formats
• 3 years ability to effectively work and communicate, in both oral and written, with all levels of the Agency from frontline workers to Executive Staff as well as the Contractor(s)
• Ability to work in a professional office environment with a diverse group of teammates
• Must have exceptional attention to detail
• Knowledge of CMS Federal Certification requirements and processes
• Project management
• MMIS experience (project or operations)

Required Education/Certifications:

Bachelor s degree in a technical, business, healthcare, or related field. Years of experience can substitute for formal education.