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Senior Business Analyst Medicaid Enterprise Systems

Hexaware Technologies, Inc

Remote • Today

Easy Apply

Full-time

Depends on Experience

Senior Business Analyst - Medicaid Systems & Cloud Modernization - ONSITE

Chandra Technologies, Inc.

Des Moines, Iowa • Today

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Contract, Third Party

Depends on Experience

Senior Business Analyst Enterprise Systems & Data Integration (Only local to IA)

COOLSOFT

Des Moines, Iowa • Today

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Contract

Depends on Experience

Business Analyst 3 - Medicaid Systems Modernization

KAIS ASSOCIATES LLC

Austin, Texas • Today

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Contract, Third Party

Sr. Enterprise Systems Technical Business Analyst

Realtor.com Careers

Austin, Texas • Yesterday

Full-time

Senior Business Systems Analyst Data, Agile & Enterprise IT

Rose International

Des Moines, Iowa • Today

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Full-time

USD 50.00 per hour

Sr Business Analyst - Enterprise

Dew Softech Inc

Trenton, New Jersey • Today

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Full-time, Part-time, Third Party, Contract

Sr. Business Systems Analyst - Enterprise Asset Management System

OnwardPath Technology Solutions LLC

Hybrid in Long Beach, California • Today

Easy Apply

Contract

Depends on Experience

Senior Business Analyst

Dexian DISYS

Brooklyn, Ohio • Today

Easy Apply

Contract

$65 - $70 per hour

Senior Business Analyst (1141)

BCforward

Brooklyn, Ohio • Today

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Contract

$70.00 - $70 per hour

Sr. Salesforce Business Analyst

Ledgent Technology

Lake Forest, California • Today

Easy Apply

Full-time

$185000 - $200000 per annum

Senior Systems Analyst - Onshore BA

Bitwise

Hybrid in Chicago, Illinois • 19d ago

Easy Apply

Full-time

Depends on Experience

Senior Business Analyst - Onsite

MSYS Inc.

Des Moines, Iowa • Today

Easy Apply

Contract

Depends on Experience

Business Analyst with COBOL/JCL & Medicaid experience - Remote

The Dignify Solutions, LLC

Remote • Today

Easy Apply

Contract, Third Party

$50

Healthcare Medicaid Business Analyst(Medicaid/MMIS Domain)

Infinite Computer Solutions (ICS)

Remote • 2d ago

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Full-time

$70,000 - $95,000

Sr. Enterprise Analyst (Payroll)

SolutionIT, Inc.

Simi Valley, California • Today

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Contract, Third Party

Urgent opening for the Position of Senior Business Analyst in Charlotte, NC (Hybrid)

Lorven Technologies, Inc.

Charlotte, North Carolina • Today

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Contract, Third Party

Depends on Experience

Senior Business Analyst

Wise Equation Solutions Inc.

Manor, Texas • 23d ago

Easy Apply

Contract

65 - 75

Team Lead – Medicaid Analytics / T-MSIS TAF

ACI Group, Inc.

Remote • 6d ago

Easy Apply

Full-time

140,000 - 155,000

Sr. HRIS Business Analyst

Visionaire Partners

Hybrid in Irvine, California • 26d ago

Full-time

$103,685 - $134,453

SENIOR BUSINESS ANALYST

Talent Software Services, Inc

Remote • 7d ago

Easy Apply

Third Party, Contract

$50 - $53

Sr. Business Analyst

Swanktek Inc

Hybrid in Charlotte, North Carolina • Today

Easy Apply

Contract

Depends on Experience

Lead Business Analyst - Only Local to MI

IntelliX Software, Inc.

Hybrid in Lansing, Michigan • 29d ago

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Contract, Third Party

$50 - $55

Senior Business Analyst – Legacy Application Modernization

Dice API Test

Hybrid in Harrisburg, Pennsylvania • 9d ago

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Third Party, Contract

$85 - $85

Senior Platform Architect (MES/MMIS Focus)

Krasan Consulting Services

Remote • 7d ago

Easy Apply

Full-time

120,000 - 130,000

Senior Budget & Financial Analyst

Serenity Info Tech, Inc.

Remote • Today

Easy Apply

Contract, Third Party

Depends on Experience

Technical Project/Delivery Manager With Medicaid Experience - Remote

The Dignify Solutions, LLC

Remote • 5d ago

Easy Apply

Third Party, Contract

Depends on Experience

Senior Business Analyst (Public-sector healthcare / MITA)

Jobot

No location provided • Today

Contract

USD 50.00 - 70.00 per hour

Senior Government Healthcare Data Consultant

Marsh & McLennan Companies

Phoenix, Arizona • Today

Full-time

USD 88,000.00 - 176,000.00 per year

Senior Health Data Analyst I

Partnership Healthplan of CA

Fairfield, California • Today

Full-time

USD 106,667.05 - 138,667.16 per year

Job Details

Skills

Senior Business Analyst
Medicaid Enterprise Systems (MES)
MMIS modernization
Claims

Summary

Position: Senior Business Analyst Medicaid Enterprise Systems

100% Remote

Hiring: W2 Contract / Fulltime

Domain: Medicaid Enterprise Systems (MES) | MMIS modernization | Claims / Member / Finance

Key responsibilities

Own requirements and functional design for assigned CMdS modules (Claims, Member, Finance, and related interfaces).
Define epics, user stories, and definition of done; prioritize against Medicaid policy, MES certification goals, and release plans.
Facilitate working sessions; clarify requirements for developers and QA; resolve functional questions during build and test.
Track scope, dependencies, risks, and decisions; maintain traceability from legacy rule to CMdS design to test evidence.
Functional design (Claims, Member, Finance)
Claims: Lead functional design for claim intake, claim type assignment, validity/pricing edits, adjustment/void, crossover, encounters, remittance, and related edit disposition behavior; map legacy rules to CMdS configuration and customizations.
Member: Lead design for eligibility spans, aid category / benefit package assignment, enrollment, MCO/FFS indicators, and interfaces from state eligibility systems into CMdS Member.
Finance: Lead design for payment cycles, budget account / category of service, fund splits, ASO / F/EA and other administrative payment paths, financial transactions, and reporting/accounting controls.
Produce BRDs, FRDs, process flows, data mapping, gap analysis, and configuration workbooks suitable for build and UAT.
Collaboration with Development & QA
Work side-by-side with developers on design walkthroughs, edge cases, and defect triage.
Partner with QA to define test scenarios, expected results, and regression packs (positive/negative, adj/void, crossover, encounter, finance posting).
Support SIT, UAT, and parallel/run-compare activities against legacy MMIS outcomes.
Validate that implementations meet Medicaid policy and MES operational readiness (security, audit, reporting, interfaces).
Stakeholder & MES engagement
Run workshops with business owners, SMEs, fiscal, and operations.
Align designs to CMS MES expectations (modularity, interoperability, standards-based interfaces, certification evidence).
Support change management: training outlines, release notes, and operational runbooks for CMdS go-live.

Required qualifications

12+ years business analysis experience in Medicaid MMIS / MES, with deep hands-on work in at least two of: Claims, Member/Eligibility-Enrollment, Finance/Financial Accounting.
Proven experience developing and implementing claims systems / MMIS / MES platforms, such as Conduent CMdS (Conduent Medicaid Suite), Health Enterprise, QNXT, Facets, or comparable commercial Medicaid/claims suites.
Experience modernizing or replacing legacy MMIS (COBOL/mainframe or equivalent) with a commercial Medicaid platform.
Strong Medicaid domain knowledge, including:
FFS vs managed care; capitation vs ASO / administrative services models
Claim types, media sources, edits/EOBs, adjustments/voids, Medicare crossover, encounters
Aid categories, benefit packages, eligibility spans, timely filing, TPL concepts
Provider payments, remittance advice, budget/object codes, COS, fund source / FFP concepts
CMS / state Medicaid policy drivers relevant to MES implementation and certification
Demonstrated ability to write clear functional design and acceptance criteria for complex adjudication and financial rules.
Experience working embedded with development and QA teams in Agile or hybrid SDLC.
Excellent facilitation, documentation, and stakeholder communication skills.

Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.

Dice Id: hexaware
Position Id: 9093704
Posted 4 hours ago

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Contact the job poster

Sagar Kumar

Talent Acquisition Specialist @ Hexaware Technologies, Inc

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Remote

•

2d ago

Job Description: Job Title: Healthcare Business Analyst Location: Remote Type: Full Time/W2 with Infinite Computer Solutions Job Description: Domain: Medicaid Enterprise Systems (MES) | MMIS modernization | Claims / Member / Finance Role summary: Serve as Business Analyst for CMdS product development and implementation on a Medicaid modernization program. Translate legacy MMIS claims, member, and finance behavior and state Medicaid policy into CMdS functional design, requirements, and acceptance

Easy Apply

Full-time

$70,000 - $95,000

Business Analyst (Healthcare domain)

Remote

•

Today

Business Analyst CMdS Claims, Member & Finance Implementation (MES) Location:Maryland (Remote) Domain:Medicaid Enterprise Systems (MES) | MMIS modernization | Claims / Member / Finance Role summary: Serve as Business Analyst forCMdS product development and implementationon a Medicaid modernization program. Translate legacy MMIS claims, member, and finance Behavior and state Medicaid policy into CMdS functional design, requirements, and Acceptance criteria. Partner with development, QA, archite

Easy Apply

Contract, Third Party

50 - 55

Senior Platform Architect (MES/MMIS Focus)

Remote

•

7d ago

Job Title: Senior Platform Architect (MES/MMIS Focus) Location: Remote Position Summary The Senior Platform Architect will serve as a key technical and strategic leader responsible for designing, documenting, and optimizing enterprise-scale platform architectures that enable digital transformation, operational efficiency, and business agility. This role specifically requires deep domain expertise in Medicaid Enterprise System (MES) Modules and a proven track record of modernizing legacy Medicai

Easy Apply

Full-time

120,000 - 130,000

CMS Certification Specialist

Remote

•

Today

CMS Certification Specialist Description: Diversified Systems is searching for aCMS Certification Specialist leads efforts to obtain and maintain CMS certification for Medicaid system modernization initiatives and serves as the primary liaison between the project team, the State Medicaid Agency, and CMS reviewers. Responsibilities:Developing certification strategies and plansPreparing and managing certification documentation and deliverablesCoordinating CMS reviews and certification milestonesMo

Easy Apply

Third Party, Contract

Depends on Experience