Medicaid Business Analyst - Consultant

SCOPE OF THE PROJECT:

SCDHHS is undertaking a multi-year Medicaid Enterprise System (MES) Modernization effort to replace the State’s aging MMIS and related applications with more modern capabilities along with corresponding business operations services.

The MES Modernization effort will be incremental and modular in nature with a focus on configurable and scalable integrations, which allow for more flexibility and reduces time and cost necessary to respond to federal and state enhancements.

The Delivery of Automated Systems for Healthcare (DASH) Program is the project management program that will be managing the MES Modernization.

DAILY DUTIES / RESPONSIBILITIES:

The Business Analyst will serve as a liaison between the business community and the IT organization to provide technical solutions to meet user needs. They will work with the Program Manager and the Lead Project Managers and will support the Project Management team to ensure the principles, business goals and values of the program are met. The Business Analyst will:

• Possess expertise in the business unit(s) they support, as well as an understanding of the IT organization's systems and capabilities
• Analyze business partner's operations to understand their strengths and weaknesses to determine opportunities to automate processes and functions
• Assist in the business process redesign and documentation as needed for new technology
• Translate high level business requirements into functional specifications for the IT organization and manage changes to such specifications
• Educate the IT organization on the direction of the business
• Negotiate agreements and commitments by facilitating communication between business unit(s) and IT from initial requirements to final implementation
• Possess an understanding of technological trends and use this knowledge to bring solutions to business units supported to enhance the enterprise's competitive edge

General Duties and Responsibilities:

• Perform business process analysis and performance assessments for the assigned projects
• Train and mentor team members in delivering high quality business solutions that meet the overall strategy and vision
• Build positive relationships with clients and proactively address specific needs
• Lead business design sessions within assigned modules and work streams
• Advocate and lead business integration in support of the MES Modernization
• Drive, though dynamic discussion, efficient configuration of data within the core modules of MES Modernization
• Provide liaison role between business and IT verticals
• Ensure project deliverables for each project connect to the operational principles
• Coordinate priorities and resources between multiple projects.
• Provide updates on status and issues for all assignments
• Participate in scheduled operational meetings and routine team leads meetings
• Lead cross-functional meetings and produce business designs that integrate functionality across modules
• Facilitate sessions to effectively resolve issues if any
• Provide recommendations of appropriate resources if necessary to ensure assignments are completed within given time and budget
• Create and maintain key performance indicators to indicate project progress toward business integration goals

REQUIRED SKILLS (RANK IN ORDER OF IMPORTANCE):

• At least seven years of experience in commercial healthcare
• At least three years’ experience in State Medicaid payer system integration and delivery
• Experience with inner workings of cross functional projects
• 1+ year Familiarity with Medicaid Information Technology Architecture (MITA) business architecture principles
• 1+ year Familiarity with standard data structures, electronic data interchange, processes and related file formats
• Interest, skill and ability to innovate including business processes, methods/procedures, and technology
• Ability to effectively work and communicate, in both oral and written, with all levels of the Agency from frontline workers to Executive Staff as well as the Contractor(s)
• Ability to work in a professional office environment with a diverse group of teammates
• Must have exceptional attention to detail

Required Skills:

• 7+ years of experience in commercial healthcare
• 3+ years’ experience in State Medicaid payer system integration and delivery
• 1+ year with Medicaid Information Technology Architecture (MITA) business architecture principles
• 1+ year with standard data structures, electronic data interchange, processes and related file formats (SharePoint, Microsoft Suite)

PREFERRED SKILLS (RANK IN ORDER OF IMPORTANCE):

• Large business and technology integration
• Commercial integrations with Medicaid or other Government operations
• Knowledge of Federal Certification requirements and processes
• Project management
• Experience with full project management lifecycle

REQUIRED EDUCATION/CERTIFICATIONS:

• Bachelor’s degree in a technical, business, or healthcare field or equivalent experience.

PREFERRED EDUCATION/CERTIFICATIONS:

• None required.