Provider Enrollment Business Analyst

Texas Health and Human Services Commission

$69K — $114K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree in IT, business administration, or related field.
  • Experience in developing business or technical requirements for automated systems.
  • Proven track record with Agile teams, particularly in Scrum or similar frameworks.
  • Prior work within state or federal government healthcare programs preferred.
  • Experience collaborating with external software vendors and third-party developers.

Responsibilities

  • Lead technology projects within the Provider Enrollment unit.
  • Analyze and align healthcare IT systems with business operations effectively.
  • Develop and manage business requirements for the Provider Enrollment process.
  • Facilitate stakeholder discussions to gather business needs and propose solutions.
  • Evaluate and test system defects to ensure compliance and performance standards.
  • Assist in resolving provider enrollment complaints and escalations promptly.
  • Coordinate and document project progress and reporting using relevant tools.

Benefits

  • Eligible for telework, with the requirement of in-office attendance three days a week.
  • Engagement in a collaborative environment that fosters teamwork and professional growth.
  • Opportunities for technical training and skill enhancement in healthcare IT systems.
  • Work within an organizational structure valuing integrity and high professional standards.
Full Job Description
Functional Title: Provider Enrollment Business Analyst Job Title: Information Technology BA III Agency: Health & Human Services Comm Department: Daily Operations Claims Admin Posting Number: 18135 Closing Date: 07/02/2026 Posting Audience: Internal and External Occupational Category: Business and Financial Operations Salary Range: $5,797.66- $9,508.25 Pay Frequency: Monthly Salary Group: TEXAS-B-25 Shift: Day Additional Shift: Telework: Eligible for Telework Travel: Up to 10% Regular/Temporary: Regular Full Time/Part Time: Full time FLSA Exempt/Non-Exempt: Exempt Facility Location: Job Location City: AUSTIN Job Location Address: 701 W 51ST ST Other Locations: MOS Codes: 8846,8848,8858,14NX,15AX,16KX,181X,182X,1D7X1,255A,25B,26B,62E,681X,682X,781X,782X,CYB10,CYB11,ISM IT,Z Prefix Brief Job Description: The Texas Health and Human Services Commission (HHSC) Medicaid & CHIP Services (MCS) department seeks a highly qualified candidate to fill the position of Business Analyst III (BA III) in the Provider Enrollment (PE) unit. Healthcare providers who want to participate in Texas Medicaid must enroll in the program and periodically revalidate their enrollment. The PE unit oversees the policies, operations, and systems that support the provider enrollment process. This position will support PE systems including the Provider Enrollment Management System (PEMS). The ideal candidate thrives in an environment that emphasizes teamwork to achieve goals, excellence through high professional standards and personal accountability, curiosity to continuously grow and learn, critical thinking for effective execution, and integrity to do things right even when what is right is not easy. The BA III reports to the PE Manager and serves as a technical lead for the PE program. Activities for this position include working with agile/scrum teams of contracted software vendors to implement system changes; performing analysis of systems and business processes to ensure alignment with business operations; overseeing and coordinating development of business requirements; performing project management tasks; leading external stakeholder discussions to provide track feedback on upcoming system requirements; and participating in PE system compliance reviews and other projects as assigned. Essential Job Functions (EJFs): Agile Management - Serves as the technical lead for PE technology projects. Works with agile/scrum teams of contracted software vendors to implement system enhancements, maintenance and changes through the Scaled Agile Framework (SAFe Agile) software development methodology (or other methodologies). Develops, refines, and prioritizes epics, user stories, and product backlog items. Documents project work through reporting tools. Consults with subject matter experts to get input on technology changes. Monitors throughput of scrum team and sprint cycles to ensure performance targets are met. (30%) Business Analysis - Performs analysis of multiple interrelated systems and business processes to ensure alignment with business operations. Coordinates across the PE program and external stakeholders to develop system requirements and business processes that align with strategic goals and objectives. Recommends and oversees the development and integration of new operational or systematic methods and procedures to improve the program and resolve identified issues. Reviews system functionality against documented requirements to determine if the system is performing as expected. Assesses system defects for business impact and verifies that solutions comply with system and program requirements. Ensures severity levels of defects are. (25%) Assigned correctly. Ensures defects are tested before being promoted into production. Coordinates with HHSC contract management to ensure that defects are resolved timely per the contractual SLAs. Analysis and Requirement Development - Oversees and coordinates development of business requirements for Provider Enrollment. Analyzes PE systems data, claims processing systems, and other related systems to identify and make recommendations for business requirement updates or new projects. Develops, or assists with developing project intake requests and system change requests. (20%) Stakeholder Liaison & Communications - Represents the PE unit in stakeholder workgroups to elicit business requirements and present proposed solutions. Responds to inquiries. Prepares and approves written reports for department leadership. Ensures communication related to PE. (10%) Special Projects - Assists staff with technical research to resolve complaints and provider escalations. Communicates directly with stakeholders to troubleshoot issues and provide resolution. Reviews PE policies and procedures, training deliverables, and other PE activities. (10%) Complaints and Escalations - Assists the HHSC Agency with provider enrollment related complaints, escalations, and requests for information. Provides accurate, comprehensive and timely responses to escalations and complaints. (05%) Knowledge, Skills and Abilities (KSAs): Knowledge in: Knowledge of healthcare IT systems preferred. Knowledge of standard business analysis concepts and practices. Knowledge of the agile software development life cycle. Skills in: Skill in analyzing and evaluating complex program and policy issues. Skill in developing and documenting business requirements. Skill in analyzing and evaluating highly complicated information and presenting to stakeholders. Skill in facilitating meetings. Skill in eliciting business needs from subject matter experts. Abilities in: Ability to identify and analyze system issues and determine business impacts. Ability to analyze systems and procedures. Ability to communicate effectively. Ability to analyze and interpret state and federal laws, regulations, and policies. Ability to train and lead teammates. Ability to evaluate systems for compliance with business and technical requirements. Registrations, Licensure Requirements or Certifications: Certified Scrum Product Owner or Certified Scrum Master (CSM) preferred. Initial Screening Criteria: Graduation from an accredited four-year college or university with major course work in information technology, business administration, or a related field. Experience and education may be substituted on a year-for-year basis. Experience in developing business or technical requirements for automated systems. Experience facilitating review of business or technical requirements with stakeholders. Experience with product ownership. Experience working with an Agile (Scrum or similar) team. Experience with state or federal government healthcare programs or policy preferred. Experience working with healthcare systems preferred. Experience working with third-party developers preferred. Additional Information: 1. Your application must be complete and contain all the requested information. Job histories must demonstrate how you meet the initial selection criteria at a minimum. 2. Any employment offer is contingent upon available budgeted funds. The offered salary will be determined in accordance with budgetary limits and the requirements of HHSC Human Resources Manual. 3. Interviews may be conducted online via Microsoft Teams. Applicants should have ability to meet using virtual meeting tools. 4. This position may be eligible for telework in accordance with the HHSC Telework Policies, which includes in-office attendance three days a week. Telework policies are subject to change. 5. Applicants selected for an interview will complete an in-basket exercise as part of the interview process. Review our Tips for Success when applying for jobs at DFPS, DSHS and HHSC. Active Duty, Military, Reservists, Guardsmen, and Veterans: Military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position may include, but not limited to those listed in this posting. All active-duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information please see the Texas State Auditor's Job Descriptions, Military Crosswalk and Military Crosswalk Guide at Texas State Auditor's Office - Job Descriptions.

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