Role Title: Business Systems Analyst – Integrated Eligibility & Healthcare
Location: REMOTE
Duration: 6+ Months (EXTENDABLE)
Required exp: 7+ years
Type: W2 Only
Client: State of TX
Note: Need state client experience and this is not on c2c requirement
Business Systems Analyst – Integrated Eligibility & Healthcare
Professional Summary
Business Systems Analyst with experience supporting complex healthcare and public-sector technology initiatives, specializing in Integrated Eligibility, Eligibility Determination, Medicaid, SNAP, TANF, CHIP, and public assistance programs. Skilled at bridging the gap between business stakeholders, government program teams, product owners, developers, QA teams, and external vendors to translate business policies and program requirements into clear, actionable system requirements.
Experienced in requirements elicitation, business process analysis, functional specifications, user stories, acceptance criteria, business rules, data mapping, system integration, UAT, defect management, and end-to-end SDLC delivery. Strong ability to analyze eligibility and enrollment processes, identify gaps, document current and future-state workflows, and ensure technology solutions accurately support state and federal program requirements.
Core Responsibilities
- Collaborate with state government, healthcare, human services, program, and technical stakeholders to gather, analyze, validate, and document business and system requirements.
- Analyze Integrated Eligibility and Enrollment (IE&E) processes supporting programs such as Medicaid, CHIP, SNAP, TANF, and other public assistance programs.
- Translate federal and state policies, regulations, program rules, and business needs into detailed functional and technical requirements.
- Document eligibility determination rules, income calculations, household composition, verification requirements, benefit calculations, program interactions, and eligibility outcomes.
- Conduct stakeholder interviews, requirements workshops, discovery sessions, and JAD sessions to identify business needs, process gaps, dependencies, and system impacts.
- Develop Business Requirements Documents (BRDs), Functional Requirements Documents (FRDs), use cases, process flows, business rules, data dictionaries, and requirements traceability matrices.
- Create detailed user stories and acceptance criteria for Agile development teams.
- Analyze current-state and future-state business processes and recommend opportunities for process improvement, automation, and system modernization.
- Perform gap analysis and impact analysis for policy, regulatory, system, and business-process changes.
- Work closely with developers, architects, QA analysts, product owners, and vendors to clarify requirements and resolve functional questions.
- Analyze system interfaces and data exchanges between eligibility systems, healthcare systems, state agencies, and external applications.
- Perform data mapping and data analysis to validate information flowing between source and target systems.
- Use SQL and other analytical tools to investigate data, validate system behavior, identify discrepancies, and support defect resolution.
- Develop and execute functional test scenarios, test cases, and expected results based on business requirements.
- Support System Integration Testing (SIT), User Acceptance Testing (UAT), regression testing, and end-to-end eligibility testing.
- Validate that eligibility decisions and benefit calculations generated by the system align with documented business rules and program requirements.
- Identify, document, prioritize, and track defects through resolution while working closely with development and QA teams.
- Support production implementation, release planning, issue resolution, and post-production validation.
- Maintain requirements traceability from business policy → requirements → development → testing → implementation.
- Facilitate communication between business and technical teams and translate complex technical concepts into clear business language.
- Prepare process documentation, training materials, system documentation, presentations, and status updates for stakeholders and project leadership.
- Participate in Agile/Scrum ceremonies, including sprint planning, backlog refinement, daily stand-ups, sprint reviews, and retrospectives.
- Support large-scale state healthcare and human-services modernization initiatives, including legacy-system replacement, cloud transformation, system integration, and eligibility platform modernization.
Key Skills
Business Analysis: Requirements Elicitation, Requirements Management, Business Process Analysis, Gap Analysis, Impact Analysis, Business Rules, Use Cases, User Stories, Acceptance Criteria, Functional Requirements, Process Modeling
Healthcare & Government: Medicaid, CHIP, SNAP, TANF, Integrated Eligibility, Eligibility Determination, Eligibility & Enrollment, Public Assistance, Health & Human Services, State Government, Human Services, Healthcare IT
Testing: UAT, SIT, Functional Testing, Regression Testing, End-to-End Testing, Test Case Development, Defect Management, Requirements Traceability
Technical: SQL, Data Analysis, Data Mapping, APIs, XML, JSON, System Interfaces, Database Analysis, Application Integration
Tools & Methodologies: Jira, Confluence, Microsoft Excel, Visio, Lucidchart, Agile, Scrum, SDLC, Waterfall, JAD Sessions
Ideal Candidate Profile
- Strong understanding of business analysis principles and software development life cycle.
- Experience working with healthcare, government, human services, Medicaid, or public-benefits systems.
- Knowledge of Integrated Eligibility and Eligibility Determination processes.
- Ability to interpret complex business rules and translate them into system requirements.
- Strong analytical, problem-solving, documentation, and communication skills.
- Comfortable working with both business stakeholders and highly technical development teams.
- Experience supporting large-scale enterprise applications and system integrations.
- Ability to manage multiple requirements, dependencies, defects, and priorities in a complex project environment.
