Hi Associates,
Hope you are doing great...!!!
I have an urgent requirement of *HealthCare Business Analyst *position in
*Columbia, SC*. Please go though the below requirement and forward me your
consultant resumes with contact details ASAP..
*Please send profiles to
**anthony.mich...@catstaffing-us.com*<anthony.mich...@catstaffing-us.com>
* ASAP*
*Job Title:HealthCare Business Analyst
Term: 12 +Months contract
Location: Columbia, SC*
*Job Description:*
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 with good language skills, and a focus on
delivery of high quality work products
*DAILY DUTIES / RESPONSIBILITIES:*
A Replacement MMIS Subject Matter Expert (SME) is responsible for
evaluating agency needs, as-is and to-be business processes, and solution
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.
Subject matter areas include: provider management, member (beneficiary)
management/eligibility, claims (professional, institutional, pharmacy,
dental, durable medical equipment, transportation, etc.), third party
liability, financial management, reimbursement methodology, drug rebate,
prior authorization, managed care, behavioral health, long-term care,
program integrity, electronic health records, benefit plan administration,
etc.
Familiarity with ICD-9/ICD-10 coding standards, X12 EDI transactions, and
the Affordable Care Act and it impacts on Medicaid eligibility and health
insurance exchanges is also beneficial.
*REQUIRED SKILLS (RANK IN ORDER OF IMPORTANCE):*
General Medicaid or Medicare Experience Required.
Strong background and proven experience in healthcare insurance business
operations (payer or provider side; government or commercial side).
Experience in multiple business areas is a plus. Note: IT operations are
not the same as business operations.
At least one year 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.
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.
*PREFERRED SKILLS (RANK IN ORDER OF IMPORTANCE):
*Understanding of the Medicaid Information Technology Architecture (MITA).
Understanding of the Medicaid Enterprise Certification Toolkit (MECT).
Vendor management experience.
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.
*Thanks & Regards*
*Anthony Michael *
Technical Recruiter
CAT Technology Inc.
Voice: 201-257-5081 ext 163| Fax: (201) 348-2385
Hackensack Avenue | New Jersey.
*Email*: anthony.mich...@catstaffing-us.com;
*G-mail* : anthony.catamerica
Visit us at: www.catamerica.com | www.cattechnologies.com
"Committed to Human Excellence Through IT"
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