Title: Business Analyst - Remote
Mandatory skills:
Data Analysis, Policy Support,
Provider management, Benefit plan, Claims, encounters,
provider enrollment system, end-to-end project lifecycle, LTC provider enrollment, user reliability,
business requirements, review of design documentation, flowcharts, file, report layouts, User Acceptance Testing, conduct Production Verification,
document data inconsistencies, system bugs, project tracking systems,
SAS, OnBase case, EDW, DAR, data extraction, assess network adequacy, Microsoft Excel, SAS Systems, Tableau, data analysis software,
charts, graphs, reports, tables, presentation materials,
Medicaid MMIS, eligibility, enrollment system, CARES
Description:
Under the general supervision of the Section Manager, this position is primarily responsible for the operational administration of the adult long-term care (LTC) provider enrollment system.
1. System Project Management & Oversight
Serve as the primary point of contact for assigned systems projects.
Provide operational administration over the adult long-term care (LTC) provider enrollment system.
Lead the end-to-end project lifecycle including the development of business requirements, review of design documentation, flowcharts, file and report layouts, coordinate User Acceptance Testing, and conduct Production Verification to ensure the system changes meets client needs.
Identify and document data inconsistencies or system bugs and work with vendors to resolve operational issues.
Provide direction and technical assistance to internal and external teams to update, manage, analyze the system.
2. Data Analysis & Policy Support
Utilize SAS and OnBase case and project tracking systems to execute regular and ad hoc queries from the EDW/DAR for data extraction in support of advancing adult provider enrollment, assess network adequacy, and conduct other policy research as assigned.
Analyze client policies, client regulations, statutes, administrative codes and guidelines to inform necessary maintenance and enhancements to assigned systems areas.
Learn and understand data, interfaces, and extracts and make conclusions to be presented to leadership for decision making purposes.
Conduct review of trends and utilization patterns of adult LTC provider enrollment related data, interfaces, and extracts systems and make recommendations to management.
Update, input and maintain the adult LTC provider enrollment system integrity and user reliability.
If applicable, conduct research and provide ongoing information and consultation to client leadership and vendor(s) to maintain and improve adult LTC provider enrollment system operations.
3. Coordination & Collaboration
Independently resolve problems by working with appropriate staff or vendor staff to identify and resolve any conflicts in the adult LTC provider enrollment system and its operation(s).
Meet with client staff, contracted agencies, and long-term care providers to determine systems problems, prepare analysis of identified problems, develop systems specifications and tests to correct problems and monitor their implementation.
Present data in a usable format for client staff and leadership in the appropriate form of charts, graphs, reports and tables.
When requested, present data orally with appropriate presentation materials.
Independently work with appropriate staff or vendor staff to identify, research, and resolve data, interfaces, and extracts validity and integrity issues.
Position Skills, Abilities, and Knowledge:
Proficient knowledge of the Medicaid MMIS including the systems operated by the fiscal agent (interChange and OnBase), the EDW/DAR (SAS), and the eligibility/enrollment system (CARES) including the basic operation of these systems and their capabilities.
Experience with the system development life cycle, with skills in the areas of business requirements development and ensuring consistent quality.
Extensive knowledge of Microsoft Excel, SAS Systems, Tableau, and/or other data analysis software.
Knowledge of research design methods, management reporting techniques, and statistics.
Advanced oral and written communication and presentation skills.
Knowledge of the client adult long-term care programs.
Extensive knowledge of Medicaid and other health care program reporting and data.
Knowledge and ability to analyze large datasets and interpret results from statistical tools.
Extensive knowledge of Federal Health Insurance Portability and Accountability Act (HIPAA) regulations and transaction and data standards.
Ability to work independently and as part of a team.
Skill in conducting meetings and working effectively with people.
Skill in the use of problem-solving techniques involving complex situations and multiple viewpoints.
Demonstrated ability to collaborate with public and private agencies and service delivery systems.
Experience working in a complex, matrix work environment.
Top Skills & Years of Experience: 3 to 5 years of experience performing a business analyst role supporting client Medicaid and MMIS, or similar health care business
System Project Management and Oversight
Data Analysis and Policy Support
Coordination and Collaboration
Nice to have skills:
o Certified Business Analysis Professional (CABP) preferred
Excellent interpersonal communication skills
Excellent organization and time management skills
Additional Details: Industry skills and experience
3 to 5 years of experience performing a business analyst role supporting client Medicaid and MMIS, or similar health care business and system in one or more of the following functional areas:
Provider management
Member (recipient) eligibility and enrollment
Claims and encounters
Benefit plan
Notes:
This position is remote
Monday through Friday, 8:00 a.m. 5:00 p.m.
VIVA USA is an equal opportunity employer and is committed to maintaining a professional working environment that is free from discrimination and unlawful harassment. The Management, contractors, and staff of VIVA USA shall respect others without regard to race, sex, religion, age, color, creed, national or ethnic origin, physical, mental or sensory disability, marital status, sexual orientation, or status as a Vietnam-era, recently separated veteran, Active war time or campaign badge veteran, Armed forces service medal veteran, or disabled veteran. Please contact us at for any complaints, comments and suggestions.
Contact Details :
Account co-ordinator: Binodh M.T
VIVA USA INC.
3601 Algonquin Road, Suite 425
Rolling Meadows, IL 60008
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