*Business Analyst w/MMIS - Direct Client *
*Immediate Interview and Start ASAP!!!*



*Please send resume to s...@cncconsulting.com <s...@cncconsulting.com> *



Job Title: Business Analyst w/MMIS
Location: Columbia, SC
Duration: 12 Months
Direct Client Position

SCOPE OF THE PROJECT:
The Replacement Medicaid Management Information System (MMIS) project is
one of the largest IT projects for the State of South Carolina. It is a
multi-year effort to replace the State’s aging MMIS, eligibility system,
and related applications with a modern, service oriented architecture based
system. This project will be very complex and will demand exceptionally
high quality team members

DAILY DUTIES / RESPONSIBILITIES:
A Replacement MMIS Business Analyst (BA) 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, claims payment, and State budget assignments, financial
management, provider reimbursement methodology, drug rebate, prior
authorization, managed care, behavioral health, long-term care, program
integrity, electronic health records, benefit plan administration, etc.
Familiarity with X12 EDI transactions, and the Affordable Care Act and it
impacts on Medicaid eligibility and health insurance exchanges is also
beneficial.

EXPERIENCE REQUIRED?
• Experience with Claims Payment and Financial systems
• Experience with Medicaid budget assignments and financial general ledger
reporting
• 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.
• Agile, waterfall, SDLC, PLC
• Requirements gathering experience

PREFERRED SKILLS (RANK IN ORDER OF IMPORTANCE):
• Understanding of the Medicaid Information Technology Architecture (MITA).
• Understanding of the Medicaid Enterprise Certification Toolkit (MECT).
• Experience in an outsourced healthcare insurance operations environment.
• Experience on an outsourced IT development project.
• Experience in creating business process and business data models.
• Public sector procurement experience is a plus.

REQUIRED EDUCATION:
Bachelor’s degree.

*Please send resume to s...@cncconsulting.com <s...@cncconsulting.com> *

Thanks,
Sam
CNC Consulting, Inc.
201-546-3096
s...@cncconsulting.com

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