I have a very urgent DIRECT CLIENT requirement for *Sr. Business Analyst w/
MMIS* 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 pe...@cncconsulting.com

Job Title: Sr. Business Analyst w/MMIS
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 Subject Matter Expert (SME) 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, 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 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):
FIVE YEARS OF BUSINESS ANALYST EXPERIENCE REQUIRED?
Strong MMIS Financial Systems experience required.
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.
 Agile  Yes  1
Medicaid Management Information System (MMIS) experience  Yes  1
Outsourced IT Development Project  No  1
Healthcare Insurance IT software/systems implementations  Yes  1
System  IT Healthcare Systems  No  1
System  MECT - Medicaid Enterprise Certification Toolkit  No  1
MITA - Medicaid Information Technology Architecture  No  1
PPACA - The Patient Protection and Affordable Care Act  No  1
MMIS - X12 EDIFACT Mapping  No  1
Waterfall  Yes  1
RUP methodology  PLC - Project Life Cycle Methodology  Yes  1
RUP methodology  Vendor management experience  Yes  1
Public Sector  No  1

Additional Skills:
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.

Thanks

Peter Smith
Direct: 224-764-8535
Email ID: pe...@cncconsulting.com

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