HI Partners,
Please share your consultant matching profile at Rajesh@tekinspirations.com
Job Title: Business Analyst - Consultant
Location: Columbia, SC
Duration: 1yr
MOI: Phone
Job Description:
The principal duties of this position are to develop and maintain business requirements with associated artifacts such as requirements plans, process flows, and other models as needed.
Daily work will concentrate on these work streams:
· Member
· Provider
· Claims
· Prior Authorization
· Finance
These work streams will support the following modules for RMMIS:
· Business Intelligence System
· Administrative Services Organization (ASO) for Fee for Service (FFS) claims
· Pharmacy Benefits Administrator (PBA)
· Dental Administrative Services Organization (DASO)
· Accounting and Finance
· Third Party Liability (TPL)
· System Integration and Operations (SIOPS)
· Technology Framework (Integration Hub, Portal and Enterprise Data Services)
· RMMIS Program Management
Specific duties include, but are not limited to:
· Plan, elicit, capture, analyze and validate business, functional and technical requirements.
· Facilitate requirements elicitation sessions and walkthroughs with business and IT resources.
· Collaborate with departments to identify, document and communicate business needs and provide solutions.
Required Skills:
· 8+ years' experience in government IT projects as a business analyst or related duties
· 6+ years' experience eliciting, mining, and documenting business rules
· General Subject Matter Expertise as it relates to Medicaid or other healthcare insurance experience (project or operations)
· Firm understanding of health care payer business process
· Strong understanding of business modeling techniques
· Integrated healthcare delivery from member enrollment though to claims payment
· Business operations experience in member enrollment though to claims payment
· Commercial and Medicaid experience preferable
· Ability to effectively communicate to executive management, line management, project management, and team members.
· Experience and ability to obtain business rules and requirements information by interviewing business personnel and by mining laws, regulations, and policy documents.
· Superb written and oral communications skills, including the ability to write requirements and Use Cases. Very Strong proficiency in English is required
· Bachelor's degree in a technical, business, or healthcare field.
Preferred Qualifications:
· MMIS experience (project or operations)
· Ability to write and understand business and functional requirements
· Strong knowledge of formal business rules methodologies
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