Business Analyst with Medicaid Experience
The Business Analyst primarily functions to review, analyze, and evaluate user requirements and system functionality. Tasks will include performing detailed requirements analysis, documenting processes, and validating system performance against requirements. The Business Analyst should have a natural analytical way of thinking and be able to explain difficult concepts to non-technical users. Medicaid program and system experience are highly desired.
JOB RESPONSIBILITIES:
- Evaluating business processes, anticipating requirements, uncovering areas for improvement, and developing and implementing solutions.
- Work closely with clients, technicians, and managerial staff.
- Perform user acceptance testing.
- Contribute expertise in provider services-related business functions, including advanced knowledge in the review and approval of provider eligibility
- Lead/support requirements and design sessions
- Analyze, document and clarify system business requirements
- Create Functional Design Documents for system enhancements
- Manage scope and implementation schedules for product releases
- Support federal system certification
- Execute system tests before User Acceptance Testing
- Maintain system documentation
- Interact daily with state clients and internal customers regarding system status and day-to-day processing
- Support user staff with analysis and resolution of issue reports
- Analyze complex data and measure outcomes
- Coordinate with technical staff to sufficiently understand technical requirements, specifications, and processes
- Interact with company and client managers and perform cost/schedule monitoring
- Other duties as assigned by management
EDUCATION AND EXPERIENCE REQUIREMENTS:
- A minimum of a bachelor’s degree or four years related work experience
- Two years of direct experience as a business analyst in design, development, testing, and implementation of software
- Knowledge of Medicaid and provider enrollment business processes
- Knowledge of system design and development process Strong understanding of system testing metrics, best practices, and methodologies
- Experience with EDI X12 transactions preferred (270 – Member Eligibility, 278 – Prior Authorization, and 837 – Claims Submission, 276/277 – Claims Adjudication)
- Experience with Provider screening, certification, and credentialing activities and interfaces preferred
- Experience working with State government clients in the Medicaid systems domain preferred
- Strong interpersonal skills
- Excellent organizational, interpersonal, verbal, and written communication skills
- Ability to perform comfortably in a fast-paced, deadline-oriented work environment
- Ability to successfully execute many complex tasks simultaneously
- Ability to work as a team member, as well as independently