Senior Business Analyst

health, CMS, Visio, Waterfall, Agile, Medicare
Full Time
Depends on Experience
Work from home not available Travel not required

Job Description

Locations in Rockville, Woodlawn and Tyson's Corner



  • Analyze, assess, plan, design, and implement operational and functional baselines. 
  • Create conceptual business models to identify relevant changes needed. 
  • Assess the operational and functional baseline of complex application to define the direction and strategy for policy changes. 
  • Identify information technology inadequacies and/or deficiencies that affect the functional area’s ability to support/meet organizational goals. 
  • Support the development of functional area strategies for enhanced IT. 
  • Creating, reviewing and presenting XLC artifacts for EDPS Next Generation to Internal Review Board (IRB).
  • Understanding Medicare ‘Fee For Service’ (FFS) Internet Only Manuals and identifying the changes to the ongoing business requirements/rules.
  • Keeping updated with ongoing change requests to Medicare FFS system and documenting the impacts to EDPS Next Generation
  • Creating, reviewing, managing change requests and updating detailed business requirements impacting EDPS Next Generation.
  • Present the change request to internal change control board (ICCB) and CCB with customer.
  • Planning FFS CR’s in order to implement before policy effective data in EDPS Next Generation.
  • Participation in FFS Change Control Board Meetings and defining a pipeline to help in release planning.


Skills Required:

  • Thorough understanding of health care insurance business analysis principles, processes, and techniques (ideally claims or encounter processing)
  • Experience working on software development projects using Waterfall and/or Agile methodologies (ideally in the CMS Medicare XLC environment)
  • Ability to develop and prepare use cases, functional specifications, and technical requirements
  • Ability to understand and document end user requirements in a software development environment
  • Ability to translate end user requirements into system requirements and communicate effectively to technical developers
  • Able to assist in the enforcement of project deadlines and client constraints/limitations
  • Ability to effectively work and coordinate in a multi-contractor community to track, monitor, and resolve open risks, action items or other project related tasks to achieve project goals
  • Can work in a rapidly changing environment and work across teams and/or functional areas
  • Demonstrated team leadership and junior staff development
  • Excellent written and verbal communications
  • Strong MS Office skills (Word, Excel, and PowerPoint) and MS Visio skills
  • Eight or more years of experience, relies on experience and judgment to plan and accomplish goals, independently performs a variety of complicated tasks, a wide degree of creativity and latitude is expected.
  • Experience documenting the change requests and presenting the business rules to the CCB’s.
  • Bachelor's degree or higher in technology-related field or relevant experience in implementing software in the health information technology

Highly Desired:

  • Experience working with the Centers for Medicare and Medicaid Services (CMS) development environment
  • Working experience with CMS XLC and artifacts.
  • Experience with healthcare claims processing and payment business rules.


Posted By

Susan Smith

8182 Lark Brown Rd., Ste 300 Elkridge, MD, 21075

Dice Id : 10268099
Position Id : Senior 1
Originally Posted : 1 month ago
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