I have a very urgent DIRECT CLIENT requirement for Business Analyst in
Columbia,
SC. Please Let Me Know If you have available candidate, please reply with
their word resume, location, rate and contact number.

Please send the resumes at su...@cncconsulting.com

Job Title: Business Analyst
Location: Columbia, SC
Duration: 12 Months

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.

Thanks,

Sunny Roy
480-463-3006  Phone
su...@cncconsulting.com

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