Title: PMM Functional Analyst
Location: Rockville MD – Remote open
As a Functional Analyst with experience and expertise in Provide Management Module systems, preferably with a state agency.
This consultant acts as the inhouse expert on healthcare provider lifecycle workflows, compliance regulations, and network management workflows. This specialized resource translates complex stakeholder workflows into detailed, actionable system requirements and functional specifications for engineering teams building a Provider Management Module (PMM).
Core Responsibilities
- Requirements Engineering: Facilitate Joint Application Design (JAD) various stakeholders to gather business requirements and expectations.
- Translate operational workflows into clear functional documents, Actor-Action-Outcome use cases, and comprehensive business requirement frameworks.
- Execute current-state versus future-state gap analyses. Define the software logic needed for provider self-service portals, automated credentialing pathways, tax identification verification, and demographic management.
- Ensure the core system design complies with federal guidelines, National Committee for Quality Assurance (NCQA) standards, and state healthcare administrative criteria.
- Function as the central technical liaison. Explain intricate business architecture rules to engineers while making technical constraints clear to organizational stakeholders.
- Map the logical connections and data definitions across critical external targets. This includes Electronic Health Record systems, national provider identifier databases, and core claims processing engines.
- Validation & Testing Collaboration: Build test strategies and review user acceptance matrices to confirm software development accurately fulfills structural rules.
Required Experience & Qualifications
- Overall 10+ years of experience working with government health and human services applications/programs.
- Minimum 3 years working closely with a state or federal Provider Management system
- Experience writing functional design documents, technical schemas, and process workflows.
- Familiarity with healthcare messaging architectures, database queries (SQL) for validation, and directory configurations.
- Background with Medicaid Management Information Systems (MMIS), private commercial payer enrollment tools, or large-scale hospital credentialing portfolios.
- Hands-on experience navigating development and tracing software utilizing tools such as Jira, Azure DevOps (ADO), or Confluence.
- Strong communication skills and ability to Confidently manage, coordinate, and align competing priorities among steering committees, vendors, and operations directors.
- Break down sprawling regulatory guidelines into manageable logical phases.
Author precise functional design documentation completely independent of jargon.
About Cyquent
Cyquent is a CMMI & ISO Certified Technology Enabler providing end-to-end IT solutions and services to organizations in both the public and private sectors since 2001. We are known for delivering high-quality, scalable solutions across complex enterprise environments.
Why Join Cyquent?
This is an opportunity to work alongside a high-performing technology team supporting a wide range of enterprise and public sector clients. You’ll gain hands-on experience working on impactful projects in a collaborative and fast-paced environment.
We offer:
- Competitive salary and 401(k)
- Comprehensive health benefits (medical, dental, and vision) starting on Day 1
- Paid time off annually, plus state holidays
- Support for professional growth, including certification assistance and continued learning opportunities
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