Medicaid Business Analyst

Prophecy Technologies

$80K — $95K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • 5-7 years of experience in business analysis or Medicaid systems
  • Strong understanding of CMS certification processes and federal regulations
  • Proven ability to evaluate system compliance and validation
  • Excellent communication and coordination skills with stakeholders
  • Experience in data analysis and report preparation
  • Ability to create and manage certification documentation and checklists

Responsibilities

  • Review and validate MES systems for CMS certification compliance
  • Coordinate certification efforts with client contractors
  • Develop and implement checklists for CMS onsite evaluations
  • Conduct and document meetings with stakeholders and CMS representatives
  • Assist in preparations for CMS certification reviews and site visits
  • Analyze certification data and reports for insights and improvements
  • Support issue resolution for CMS certification challenges

Benefits

  • Health, dental, and vision insurance options
  • 401(k) retirement plan with employer match
  • Paid time off and holiday pay
  • Flexible work arrangements
  • Professional development opportunities
Full Job Description
Job Tittle : Medicaid Business Analyst

Location : Albany, NY

Overview of job:

The Senior Business Analyst will support the client's contractors with obtaining CMS certification of the Medicaid Enterprise Systems (MES). As the various MES components become operational, successful completion of the CMS Federal certification process of the MES will require the evaluation and validation of the subsystems to ensure attainment of CMS certification for the client to continue to receive Federal Financial Participation (FFP). The QA Business Analyst must be aware of any new or upcoming changes to the CMS certification process and be prepared to assist the client and its contractors in achieving certification in accordance with current and any revised CMS guidelines.

Job Responsibilities Include:

Review, evaluate and validate mandatory MES systems and subsystems to determine compliance with core CMS Federal certification requirements

Coordinate certification activities with client's contractors and staff

Establish checklists for CMS onsite visits

Attend meetings with client and CMS staff. Prepare agenda, meeting notes, decision lists and follow up action items

Support of CMS Federal certification review team/CMS Regional Office staff briefings and pre-certification meetings and calls

Assist with preparations for CMS on-site visits

Analyze data, reports, and deliverables, as needed

Assist with resolution of any CMS Federal certification issues

Review of CMS Federal certification report(s) and provide additional guidance to Department and its Contractors

Support the preparation of Department responses to CMS

Ensure all current and future CMS policies and requirements are met for system testing and attestations, as

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