SCOPE OF THE PROJECT:
This project is a multi-year effort to replace the State’s Medicaid Eligibility Determination System (MEDS) with a multi-tier application environment that requires modern technologies, technical practices and substantial collaboration with a variety of stakeholders. This system will primarily be a commercial-off-the-shelf (COTS) framework that will be configured/implemented by the State in partnership with Clemson University. Additionally, the State will be transforming its business processes away from a “caseload” model (each worker manages several hundred cases) to a process-driven model where a team of workers manages a process such as application intake, redeterminations, or complex eligibility.
DAILY DUTIES / RESPONSIBILITIES:
Business Analyst is responsible for understanding the State’s current capacity and history in developing business requirements for the development and maintenance of its MMIS/MEDS systems and then assisting the State in developing a framework, approaches, and processes to shift its requirements work away from lengthy documents toward succinct well-designed Business Process Models. Additionally, the Consultant will assist the State in developing Business Rules in a way that can be easily adapted to modern commercial rules engines and structured in a manner that is scalable and sustainable. The consultant will work with the team’s business owners, software developers, and transformation team to meet these goals.
Duties and skills to include:
• Knowledge of business processes
• Ability to have a business-oriented vision
• Improvement of business and engineering processes
• Strategic planning
• Case development
• Business writing
• Assessing the current status of business process modeling (BPM) and requirements development on this major project
• Developing processes, standards, and strategies for development of BPMs
• Educating and training team members in effective BPM development
• Developing processes, standards, and strategies for development of “rules”
• Educating and training team members in effective “rule” development
• Other duties as assigned.
We are seeking a consultant who has significant practical experience with the development of business process models and rules as a modern alternative to traditional requirements documentation. This consultant will assist the team in transitioning toward a significant process transformation and through this effort work closely with business owners, business analysts, and our development team to implement a strategy that will lead to a successful project while also making a significant impact on the culture and approach to software development and system implementation. The successful candidate will recognize that the changes contemplated in this project are much more significant than just the system/technology changes and be able to assist the project’s leadership in facilitating material change to organizational culture, processes and systems/technology
REQUIRED SKILLS (RANK IN ORDER OF IMPORTANCE):
Business Analyst has three major components: establishing requirements document and process for BPM and rules development, educating and training project staff about BPM and rule development, and participating with project leadership to influence process, culture and system transformation. Candidates must display excellence in all areas.
• Demonstrated experience as change agent/leader for major process/system transformation
• Experience and relentless focus on performance-based process management including ability to recognize key metrics
• Demonstrated experience using business process modeling as a tool for organizational and process transformation
• Experience using modern commercial rules engines
• Experience working on large technology/systems projects including product vision/management and requirements development
• Understanding of IT development lifecycle processes including experience working in agile environments
• Superb written and oral communications skills, including the ability to effectively interact with software developers and system administrators
• 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):
• Knowledge and experience with the BizAgi BPM tools
• Knowledge and experience with modern commercial rules engines
• Knowledge and experience with business activity monitoring (BAM)
• Knowledge of healthcare insurance principles and processes
• Medicaid eligibility system/business operations experience
• Medicaid Management Information System (MMIS) experience
• Medicaid operations experience
• Public sector and/or academic environment experience is a plus
Skills:
Database Platforms Agile
MMIS - Medicaid Management Informaiton System Medicade
Program Management Software Development Lifecycle - SDLC
Program Management Business Activity Monitoring (BAM)
Programming Languages BizAgi BPM Tools
Additional Skills:
Knowledge and experience with the BizAgi BPM tools
• Knowledge and experience with modern commercial rules engines
• Knowledge and experience with business activity monitoring (BAM)
• Knowledge of healthcare insurance principles and processes
• Medicaid eligibility system/business operations experience
• Medicaid Management Information System (MMIS) experience
• Medicaid operations experience
• Public sector and/or academic environment experience is a plus | 