Business Analyst---- NJ-New Jersey/Newark---6 month----telephonic + Face 2Face

M.O.I                    Telephonic + Face2Face

Solid HealthCare Experience is MUST

1).

·      Proficiency with Rule/Decision Analysis for rule based projects (ILOG). 

·      Decision Modeling and Process Modeling are key attributes. 

·      Excellent communication and documentation skills. 

·      Must be able to drive rule discovery, analysis, and documentation process. 

·      Facilitate sessions with business users/SME's. 

·      Assist business in identifying existing and new business rules. 

·      Analyze rules for completeness, correctness, optimization (from a logical, not performance, perspective).  Identify the impact of defined rules. 

·      Formalize the business terms (and phrases) used in business rules; this formalization may be in a logical data model, fact model, business object model or some other format that standardizes the terms used and their definitions. 

·      Experience in projects developed via Lombardi/BPM and/or PEGA.

 

2).

·      Experience working with Clinical applications – such as:

o  Authorization (and/or Referral) feeds, 

o  Case Management

o  Disease Management

·      Skills working with Claims processing – specific to "Auth-to-Claim" matching.

·      Technical mapping of interfaces needed to receive/send (In-bound and out-bound) data.  That data would be Membership and Provider data.

·      Understanding additional Clinical business functions, such as:

o  Correspondence Letters, Attachments and Faxes

o  Survey Assessments

o  Reports

 

3). Solid healthcare experience with Enrollment, Billing, Affordable Care Act, HIX, Software Package Integration, Middleware, ETL Data Mapping experience.

 

Thanks & Regards

 

Amit Sharma

 

Technical Resource Specialist

 

RG Talent Inc.

39120 Argonaut way Suite # 157, Fremont CA 94538 Phone :  510-443-0757 Ext-115 Fax      :  510-952-4633

Email   : amit.sharma@rgtalent.com  GTalk --> amitsharma.rgtalent YIM à amitsharma.rgtalent

In my absence please contact Javed Ansari at the following address javed.ansari@rgtalent.com  

Disclaimer: Under Bill s. 1618 Title III passed by the 105th U.S. Congress this mail cannot be considered spam as long as we include a way to be removed from our mailing list. Simply send us an e-mail at remove@rgtalent.com and we will gladly REMOVE you from our mailing list.

 

 

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