Business Analyst


Columbia, SC

Industry: Technology


8 - 10 years

Posted 21 days ago

  by    Cynet Sytems

We are looking for Business Analyst for our client in Columbia, SC

Job Title: Business Analyst

Job Location: Columbia, SC

Job Type: Contract 12 Months

"US citizens and those authorized to work in the US are encouraged to apply. We are unable to sponsor H1b candidates at this time."

Job Description:

  • The Replacement MMIS project is among the most complex IT projects taken on by our client .
  • This project is a multi-year effort to replace many of the State's aging Medicaid systems with modern technologies and supporting business operations.

Objectives to be fulfilled by candidate:

  • The principal duties of this position are to develop and maintain business requirements with associated artifacts such as requirements plans, process flows, and other models as needed.

Daily work will concentrate on these work streams:

  • Member
  • Provider
  • Claims
  • Prior Authorization
  • Finance

These work streams will support the following modules for RMMIS:

  • Business Intelligence System
  • Administrative Services Organization (ASO) for Fee for Service (FFS) claims
  • Pharmacy Benefits Administrator (PBA)
  • Dental Administrative Services Organization (DASO)
  • Accounting and Finance
  • Third Party Liability (TPL)
  • System Integration and Operations (SIOPS)
  • Technology Framework (Integration Hub, Portal and Enterprise Data Services)
  • RMMIS Program Management

Specific duties include, but are not limited to:

  • Plan, elicit, capture, analyze and validate business, functional and technical requirements.
  • Facilitate requirements elicitation sessions and walkthroughs with business and IT resources.
  • Collaborate with departments to identify, document and communicate business needs and provide solutions.
  • Develop business rules via interviews, translation of governing documents and other means.
  • Conduct JAD Sessions with Product Owners
  • Partner with business owners on requirements development and project collaboration
  • Assist other team members in performing business rules, requirements, and modeling duties.
  • Research business rules, requirements, and models.
  • Use case development
  • Requirements traceability

Required skills (rank in order of importance):

  • 8+ years' experience in government IT projects as a business analyst or related duties
  • 6+ years' experience eliciting, mining, and documenting business rules
  • General Subject Matter Expertise as it relates to Medicaid or other healthcare insurance experience (project or operations)
  • Firm understanding of healthcare payer business process
  • Strong understanding of business modeling techniques
  • Integrated healthcare delivery from member enrollment though to claims payment
  • Business operations experience in member enrollment though to claims payment
  • Ability to effectively communicate to executive management, line management, project management, and team members.
  • Experience and ability to obtain business rules and requirements information by interviewing business personnel and by mining laws, regulations, and policy documents.
  • Superb written and oral communications skills, including the ability to write requirements and Use Cases.