Business Analyst – PA MMIS Prior Authorizations

Job Title: Business Analyst – Prior Authorizations (PA) / MMIS

Location: Quincy, MA 02171 (Hybrid)

Job Type: Contract

Job Overview

Our client is seeking an experienced Business Analyst with Prior Authorization (PA) and Medicaid Management Information System (MMIS) expertise. The BA will join a collaborative MMIS team supporting Provider Reimbursement and Claims processing functional areas, including development, testing, and implementation.

Key Responsibilities

• Develop test strategies, test scenarios, and test cases based on written requirements
• Execute and review test runs; sign off on testing components
• Document requirements and support their development and testing
• Develop end-user training materials and documentation
• Provide oversight during stabilization phases, including monitoring system change execution
• Work with vendors to ensure business requirements are fully defined and tested
• Communicate updates and changes to impacted stakeholders
• Support program staff and external stakeholders with MMIS-related questions
• Perform data querying and analysis

Required Skills

• Business Analysis supporting all stages of the system project lifecycle
• MMIS knowledge — Claims Processing, Prior Authorization (PA), PAS, and Referrals
• HIPAA claims and payment transaction processing competency
• Strong SQL and data analysis skills
• Excellent written and verbal communication and documentation skills
• Ability to work independently and within cross-functional project teams
• Strong interpersonal skills for interaction with PMs, developers, QA analysts, and business users

Preferred Skills

• Medicaid systems experience and MassHealth program knowledge
• SDLC and Agile methodology familiarity
• Knowledge of Interoperability and X.12 emerging standards.