[ASP_NET_jobs] Position for Business Analyst {Medicaid Management Information Systems} in SC

Hi,

Hope you doing great. Please check the below position if you interested reply me with your updated resume along with the below details ASAP. Please reply to my ID: Kalyan@BijjamIT.com

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Role: Business Analyst {Medicaid Management Information Systems}

Location: Columbia, SC

Duration: 12+ Months

 

MUST have expertise in Medicaid Management Information Systems, X.12 EDI, ICD 9/10, and Affordable Care Act.

 

State government experience highly preferred.

 

 

Daily Duties / Responsibilities: A Replacement MMIS Subject Matter Expert (SME) is responsible for evaluating agency needs, as-is and to-be business processes, and technical designs to provide analysis and advice on strategies for information technology solutions and non-technical solutions. The majority of the system development work will be outsourced to vendors and other State organizations. Duties include: ·         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. ·         Participate in the requirements management processes, including change control; version control; tracking and status reporting; and traceability. ·         Providing requirement 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). ·         Planning for, conducting, and reporting on testing and other quality assurance activities. ·         Other related activities. Subject matter areas include: provider management, member (beneficiary) management/eligibility, claims (professional, institutional, pharmacy, dental, durable medical equipment, transportation, etc.), third party liability, financial management, reimbursement methodology, drug rebate, prior authorization, managed care, behavioral health, long-term care, program integrity, electronic health records, benefit plan administration, etc.  Familiarity with ICD-9/ICD-10 coding standards, X12 EDI transactions, and the Affordable Care Act and it impacts on Medicaid eligibility and health insurance exchanges is also beneficial.

Required Skills (rank in order of Importance): ·         Analytics Background required ·         Strong background and at least six years experience in healthcare insurance business operations (payer or provider side; government or commercial side). Note: IT operations are not the same as business operations. ·         At least four years experience in healthcare insurance IT software/systems implementations performing duties described in the "Daily Duties/Responsibilities" section above. ·         Ability to properly document business requirements. ·         Ability to interpret business process and business data models. ·         Vendor management experience. ·         Superb written and oral communications 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.

 

 

Thanks and regards,

 

Kalyan Buggapati

Bijjam Information Technologies, Inc.

3525 West Peterson Ave, Suite 310

Chicago, IL 60659-3315

Tel: 773-782-6130

Fax: 773-913-0527

Gtalk: atums.kalyan@gmail.com

 

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