I have a very urgent DIRECT CLIENT requirement for Systems 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: Systems 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 Systems Analyst is responsible for evaluating agency
needs, as-is (legacy systems) and to-be (proposed) system processes.
Provides 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:
Analyze existing legacy code (COBOL, JCL, etc.) and documents existing
as-is processes identifying all inputs, system processes, and outputs.
Analyze and document data requirements and relationships.
Document policy requirements and business rules to be carried over as to-be
requirements in the form of user stories.
Develop programming specifications to support development team(s).
Work closely with the Enterprise Architect and Technical Manager in
obtaining and validating artifacts of legacy system and future enterprise.
Actively participate in project scrum team(s) in assisting with release
planning, software development, testing, and implementation.
Proactively identifying risks, issues, and action items leading to possible
solutions.
Interacting with internal and external organizational teams (i.e. vendors,
State and Federal government agencies, State providers and beneficiaries,
and other stakeholders).
Other related activities as assigned.
Subject matter areas include: Provider Management, Member (beneficiary)
management/eligibility, Claims editing and pricing (professional,
institutional, pharmacy, dental, durable medical equipment, transportation,
etc.), Claims Payment and State budget assignment, Financial Management,
Provider re-imbursement methodology, third party liability, 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 is also beneficial.

REQUIRED SKILLS (RANK IN ORDER OF IMPORTANCE):
FIVE YEARS AS SYSTEMS ANALYST
Claims Payment experience required in analyzing current as-is legacy system
processes.
Experience with Medicaid budget assignments and financial general ledger
reporting;
Experience with Claims Payment interactions with provider and financial
system(s);
Experience in financial systems (AR, AP, payment reductions, general ledger
postings and reporting, etc.);
Experience in State and Federal Medicaid financial reporting;
Strong experience with legacy code (COBOL; JCL, etc.) in reading,
interpreting, and documenting current processes and requirements.
Strong Claims Payment and Financial background with at least five years
experience in Medicaid IT systems operations (payer/provider side). Note:
IT operations are not the same as business operations;
At least four years experience in Medicaid IT software/systems
implementations performing duties described in the “Daily
Duties/Responsibilities” section above.
Ability to properly document as-is and to-be system requirements.
Ability to create/interpret system and 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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