Expert Business Analyst Medicaid Contract Compliance System (100% Remote work)

  • Posted 1 day ago | Updated 1 day ago

Overview

Remote
$40 - $70
Full Time

Skills

Business Analysis
Medicaid Managed Care
Medicaid Compliance
Contract Compliance Tracking
CFR 42
Health Policy
Data Validation
Test Case Development
UAT
Workflow Mapping
Process Documentation
JIRA
Confluence
Power BI
Tableau
Visio
Audit Readiness
CMS Reporting
MES
Agile
Government IT Projects
Stakeholder Engagement
Production Support

Job Details

Now Hiring: Expert Business Analyst Medicaid Contract Compliance System


Work Mode: 100% Remote
Duration: 24+ Months (Long-Term Contract)


Role Overview

A state health and human services agency is seeking an experienced Business Analyst to lead the implementation and support of a Contract Compliance Tracking System for Medicaid Managed Care programs. This system plays a critical role in meeting federal and state oversight requirements and enhancing accountability through dashboards, workflows, and data-driven decision-making.

The successful candidate will bring deep domain knowledge of Medicaid Managed Care, compliance processes, and health policy, and will be skilled in business analysis, data validation, and stakeholder engagement.


Key Responsibilities

<> Business Analysis & Requirements Management</>
  • Lead end-to-end business analysis for the design and support of a Medicaid compliance tracking system

  • Define and document requirements, workflows, business rules, and data mapping

  • Create process flows, use cases, and business documentation aligned with federal compliance needs

<> Testing & Quality Assurance</>
  • Develop and execute test cases for UAT, regression, and system integration

  • Support user testing, gather feedback, and assist in training and go-live support

  • Oversee issue tracking and work with technical teams to ensure timely resolution

<> Compliance Dashboards & Reporting</>
  • Manage dashboard and reporting functionalities related to compliance metrics, CAPs, KPIs, and audit readiness

  • Identify opportunities for workflow improvements and support automation initiatives

<> Stakeholder Collaboration</>
  • Serve as a liaison between business units, IT, and Managed Care Organizations (MCOs)

  • Facilitate requirements validation, prioritization, and communication across teams

  • Coordinate and support production support triage and resolution tracking


Required Qualifications

  • 5+ years experience as a Business Analyst, with 3+ years in Medicaid Managed Care or similar public sector health programs

  • In-depth understanding of federal Medicaid regulations (e.g., CFR 42, MCO compliance)

  • Hands-on experience with:

    • Requirements documentation

    • Process mapping

    • Business rule definition

    • Data validation and test case creation

  • Proficient in UAT facilitation and production support coordination

  • Strong communication and technical documentation skills

  • Familiar with tools such as JIRA, Confluence, Visio, Excel, and reporting platforms (Power BI, Tableau)


Preferred Qualifications

  • Bachelor s degree in Health Administration, Information Systems, Public Policy, or related field

  • Experience in a state Medicaid agency supporting compliance or case tracking systems

  • Familiarity with Medicaid Enterprise Systems (MES), CMS reporting, and audit frameworks

  • Experience with workflow automation and dashboard development

  • Knowledge of Agile/Scrum methodology and collaborative tools (JIRA, Confluence)

  • Demonstrated ability to work across policy, business, and IT teams in a government setting


Skills Summary :

Business Analysis, Medicaid Managed Care, Medicaid Compliance, Contract Compliance Tracking, CFR 42, Health Policy, Data Validation, Test Case Development, UAT, Workflow Mapping, Process Documentation, JIRA, Confluence, Power BI, Tableau, Visio, Audit Readiness, CMS Reporting, MES, Agile, Government IT Projects, Stakeholder Engagement, Production Support



Apply now if you're a Medicaid-savvy analyst with a passion for compliance and public health innovation!

Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.