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Company: ACROSTAFF Jobs
Contact Name: DAVE

Job Details: Business Analyst with Medicaid Experience Date: Nov 25 2021

Job Reference: 10389
Job Category: IT Jobs [ View All IT Jobs Jobs ]
Company Type Employer
Employment type: Full Time
Degree: High School
Experience: 3 years
Location: Columbia, Connecticut, 06237
Job Skills: Business Analyst with Medicaid Experience
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Job Description

Required Skills:
• Subject matter areas include member related eligibility determination, enrollment and disenrollment, eligibility inquiry, program policy, and state plan. Familiarity with the Affordable Care Act and impacts on Medicaid eligibility and member related processes is also beneficial.
• Strong background and at least four years in social services and/or healthcare insurance operations (payer or provider side; government or commercial side).
• At least (3) years of experience in social services and/or healthcare insurance IT software/ systems implementations.
• Minimum of (3) years of experience in business application consulting, training or development.
• Experience in business process analysis (Use Cases and/or process flows) and mapping (Gap Analysis) techniques.
• Ability to properly document business requirements and business rules.
• Ability to establish and maintain effective working relationships with customers.
• Ability to organize, prioritize and follow complex and detailed procedures.
• Capable of performing job with minimal supervision.
• Superb written and oral communication skills, including the ability to give presentations to executive management. Strong proficiency in English is required.
• Impeccable integrity. This project will have very high visibility and will impact significant expenditures of public funds. Candidates must be confident with their abilities to make correct decisions and the courage to speak out when necessary.
• Willingness and ability to effectively engage with people and organizations on a continuous basis.

Preferred Skills:
• Experience in Curam social program management platform
• Medicaid eligibility system/business operations experience
• Knowledge and experience with the BizAgi BPM tools
• Knowledge of healthcare insurance principles and processes
• Medicaid operations experience
• Medicaid Management Information System (MMIS) experience
• Public sector and/or academic environment experience is a plus

Eligibility and Enrollment Member Management Project is one of the largest IT projects for the State of South Carolina.

It is a multi-year effort to replace the State’s aging Medicaid Eligibility Determination System and other member management applications with a with a multi-tier application environment that requires modern technologies, technical practices and substantial collaboration with a variety of stakeholders.

This system will primarily be a commercial-off-the-shelf (COTS) framework that will be configured/ implemented by the State in partnership with Clemson University. SC uses the social program management platform from IBM Curam in the provision of services.

This software combines the advantages of commercial off-the-shelf software, an enterprise platform and service-oriented architecture with the business and technical flexibility required to implement solutions to meet agency objectives.

• Requirements development execution, including the elicitation, analysis, specification and validation.

• Documenting and analyzing agency business processes and recommending improvements.

• Documenting and analyzing data requirements and relationships.

• Participating in the requirements management processes, including change control, version control, tracking and status reporting, and traceability.

• Providing requirements interpretation and guidance to technical and test teams.

• Proactively identifying risks, issues, and action items leading to possible solutions.

• Interacting with internal and external organizations (i.e. vendors, State and Federal government agencies, State providers and beneficiaries, and other stakeholders).

• Participating in standup of business operations supporting the Eligibility and Enrollment Member Management Project.

• Planning for, conducting, and reporting on testing and other quality assurance activities.

• Other duties as assigned.

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