Overview
Skills
Job Details
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84 MONTHS Experience in system/business analysis providing executive level and operational guidance to a diverse group of users, technicians, and managers within a health care entity that deals with claims-based data sets. Must include:
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Experience with HIPAA Confidential data and New York State/Federal regulations.
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Experience writing complex SQL against the MDW
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Creating/optimizing advanced SQL queries against large relational data sets.
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Experience using Balsamiq for wireframe and screen design
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Analysis of system requirements
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Meeting with business users
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Designing system prototypes
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Creating logical data models
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Creating use cases
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Documenting existing and proposed systems within the context of a business analyst development suite
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84 MONTHS Experience with managing the development and implementation of Medicaid Audits/ Investigations case management systems, in a Microsoft. Net/Java platform and/or MS SQL/Oracle back-end environments.
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84 MONTHS Experience implementing, managing and troubleshooting electronic documents solutions, third-party APIs interfaces and OCR engines, and Xerox Docushare as the enterprise electronic document content repository.
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72 MONTHS Experience managing and supporting Medicaid audit work-papers documentation systems, involving case replication, sampling, reporting, recipient claims, findings, utilizing Microsoft .Net/C# technology.
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24 MONTHS Experience documenting the design of applications which utilize ComponentOne, Aspose, and Mathematica software.
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Education/Certification: Master's or higher degree
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Agency: Information Technology Services (ITS)
Project: FACTS, PADS and OMIG System Enhancements
Detailed Job Description: The Fraud Activity Comprehensive Tracking System (FACTS) is an electronic drawer, composed of numerous and varying databases and interfaces that permit efficient access to current and historical information on all audit and investigative activities involving Medicaid providers and/or recipients. The application is web based and is accessible in real-time by over 1,200 users across the State in five state agencies (OMIG, DOH, AG (MFCU), OSC & CQC). The FACTS system is comprised of over 30 related modules. There are several maintenance and system enhancements that will be addressed including, but not limited to: FACTS enhancements, PADS, Managed Care enhancements, audit sampling and legal.