Overview
Skills
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
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
Manage dashboard and reporting functionalities related to compliance metrics, CAPs, KPIs, and audit readiness
Identify opportunities for workflow improvements and support automation initiatives
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!