Job DescriptionSenior Business Analyst, MMIS FinanceAbout the Role Lead business and functional requirements for the MMIS Financial Management module from requirements gathering through implementation and production validation. Translate Medicaid payment operations into clear requirements for business, technical, and testing teams.
Responsibilities - Facilitate stakeholder workshops, document current-state financial processes, identify gaps, and define target-state business and system needs.
- Develop business and functional requirements, user stories, acceptance criteria, process flows, decision tables, data mappings, interface requirements, and reconciliation rules.
- Analyze the end-to-end financial lifecycle, including claims payment, preliminary and final payment cycles, warrants and EFT, remittance advice, receivables, recoveries, recoupments, refunds, offsets, voids, reissues, and reconciliation.
- Trace claims and financial transactions across adjudication, payment, 835 or paper remittance, banking, general-ledger interfaces, and financial reporting.
- Collaborate with finance, program, development, architecture, and QA teams to define screens, work queues, interfaces, batch cycles, and system behavior. Maintain requirements traceability, manage backlog priorities and requirement changes, and resolve business and testing questions throughout delivery.
- Support SIT, UAT, regression testing, defect triage, root-cause analysis, and production validation, ensuring payment cycles and financial postings reconcile.
- Assess Medicaid policy, regulatory, and CMS reporting impacts and communicate financial concepts and system behavior to technical and nontechnical stakeholders.
Requirements - Business Analyst experience with Medicaid MMIS/MES, healthcare payer systems, claims payment, or comparable financial operations.
- Knowledge of claims adjudication, provider payment, accounts payable and receivable, recoveries, adjustments, refunds, offsets, and reconciliation.
- Working knowledge of 837P, 837I, and 837D transactions and strong knowledge of the 835, including CAS, PLB, and payment balancing.
- Knowledge of Medicare crossover, coordination of benefits, and third-party liability or recovery processes that affect Medicaid payment.
- Ability to use SQL and X12 validation tools to trace claims, payments, receivables, remittances, and downstream financial data.
- Experience with requirements documentation, stakeholder facilitation, traceability, SIT, UAT, defect triage, and production validation.
Preferred Qualifications- Eight or more years of business analysis or healthcare systems experience, including MMIS financial management or Medicaid payment operations.
- Experience with CMdS or another Medicaid enterprise or healthcare payer platform such as Gainwell, QNXT, HealthRules, or Facets.
- Knowledge of CMS-64, FMAP, 1099 reporting, MITA Financial Management, X12 820, or NCPDP transactions.
- Experience with Agile delivery and backlog tools such as Azure DevOps or Jira.
Flexible Working At Conduent, we want you to be yourself. We recognize that everyone is different and that how people want to work and deliver at their best is different for everyone too.
In this role, you can expect the following working conditions:
Remote work: Enjoy the convenience of working from home and maximize your time by unplugging at the end of your workday.
Working For You
Perks and rewards designed for you:
- Health and Welfare Benefits: Our health and welfare benefits can be tailored to fit you and your family's needs and start on the first day of employment.
- Retirement Savings: We will support you as you save for your future.
Career Growth Opportunities:
We help you thrive, so together, we can grow. We provide opportunities to advance your career with a vast portfolio of businesses and a global footprint.
- Paid time off: We provide attractive paid time off packages designed for you to enjoy your life away from work.
- Great Work Environment: We are proud of our award-winning culture and the recognition we've received for our diversity efforts.
Pay Transparency Laws in some locations require disclosure of compensation and/or benefits-related information. For this position, actual salaries will vary and may be above or below the range based on various factors including but not limited to location, experience, and performance. In addition to base pay, this position, based on business need, may be eligible for a bonus or incentive. In addition, Conduent provides a variety of benefits to employees including health insurance coverage, voluntary dental and vision programs, life and disability insurance, a retirement savings plan, paid holidays, and paid time off (PTO) or vacation and/or sick time. The estimated salary range for this role is $85,470 - $111,000.
