Senior Business Analyst - Medicaid Systems in Columbus, OH

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Education, Government & Non-Profit   •  

5 - 7 years

Posted 7 weeks ago

Job Description Summary

POSITION SUMMARY: The Senior Business Analyst primarily functions to review, analyze and evaluate user requirements and system functionality. Tasks will include performing detailed requirements analysis, documenting processes, and validating system performance against requirements. The Senior Business Analyst should have a natural analytical way of thinking and be able to explain difficult concepts to non-technical users. Medicaid program and system experience are highly desired.


• Evaluating business processes, anticipating requirements, uncovering areas for improvement, and developing and implementing solutions.

• Work closely with clients, technicians, and managerial staff.

• Perform user acceptance testing.

• Contribute expertise in provider services-related business functions, including advanced knowledge in the review and approval of provider eligibility

• Lead requirements and design sessions

• Analyze, document and clarify system business requirements

• Create Functional Design Documents for system enhancements

• Manage scope and implementation schedules for product releases

• Support federal system certification

• Execute system tests before User Acceptance Testing

• Maintain system documentation

• Interact daily with state clients and internal customers regarding system status and day-to-day processing

• Support user staff with analysis and resolution of issue reports

• Analyze complex data and measure outcomes

• Coordinate with technical staff to sufficiently understand technical requirements, specifications, and processes

• Interact with company and client managers and perform cost/schedule monitoring

• Other duties as assigned by management


• A minimum of a bachelor's degree or four years related work experience

• Five years of direct experience as a business analyst in design, development, testing, and implementation of software

• Knowledge of Medicaid and provider enrollment business processes

• Knowledge of system design and development process

• Strong understanding of system testing metrics, best practices, and methodologies

• Experience working with State government clients in the Medicaid systems domain preferred

• Experience with EDI X12 transactions preferred (270 – Member Eligibility, 278 – Prior Authorization, and 837 – Claims Submission, 276/277 – Claims Adjudication)

• Significant expertise with Provider screening, certification, and credentialing activities and interfaces preferred.

• Strong interpersonal skills

• Excellent organizational, interpersonal, verbal, and written communication skills

• Ability to perform comfortably in a fast-paced, deadline-oriented work environment

• Ability to successfully execute many complex tasks simultaneously

• Ability to work as a team member, as well as independently

Essential Duties and Responsibilities:

- Support leadership in ensuring that the project is delivered to specifications, on time and within budget.

- Develop initiative strategies for provider capacity building such as evaluating business models, creating training, recruitment, events participation, outreach approach, and support activities.

- Work closely with management and work groups to create and maintain work plan documents.

- Track the status and due dates of projects.

- Manage relationships with project staff responsible for projects.

- Produce regular weekly and monthly status reports, work plan status, target dates, budget, resource capacity and other, as well as, ad hoc reports as needed.

- Collaborate with project managers on various initiatives and projects to track progress and provide support as necessary.

- Create and maintain management plans and other deliverables.

- Facilitate regular meetings and reviews.

- Evaluate employee performance and recommend employees' needs and development opportunities to leadership.

- Adhere to contract requirements and comply with all corporate policies and procedures.

- Perform other duties as assigned by management.

Minimum Requirements:

- Bachelor's degree with 5-7 years of experience consulting within designated function.

- Advanced degree preferred.

- Develop solutions to highly complex problems which require a high degree of ingenuity and innovation.

- Ensure solutions are consistent with organization objectives.

- Solutions may serve as precedent for future decisions.

- Develop advanced concepts, techniques, and standards requiring a high level of interpersonal and technical skills.

- Develop new applications based on professional principles and theories.

- Viewed as expert in field within the organization.