Business Systems Analysts

Description

Specific Duties and Responsibilities The South Carolina Department of Health and Human Services (SCDHHS) is seeking three (3) Senior Business Systems Analysts (BSAs) with extensive experience and strong healthcare insurance expertise (preferably in Medicaid) tassist with its Replacement Medicaid Management Information System (MMIS) Project. These positions are planned tbe multiyear, onsite positions, and candidates must express a willingness tcommit tthe project. General Duties The Sr. Business Systems Analysts will report tthe Requirements Manager and assist in The development/formulation and validation of all requirement engineering processes, standards, procedures, and guidelines; The requirements development execution, including the elicitation, analysis, specification and validation of requirements; The requirements management processes, including change control, version control, tracking & status reporting, and traceability; Providing leadership trequirement teams, serving as a central point of contact through mentoring and motivating other business system analysts in a positive manner; Guiding both project team members and customers in the development process; providing analysis and solution definitions, tensure solutions meet customer objectives; Providing requirement interpretation and guidance ttechnical and test teams; Proactively identifying risks, issues, and action items leading tpossible solutions; Interacting with internal and external organizations and persons as deemed appropriate by the Requirements Manager (i.e. vendors, State and Federal government agencies, State providers and beneficiaries, and other stakeholders). The MMIS Replacement Project requirements team will be involved in all phases of the project, including design, development and test; which means the Sr. Business Systems Analyst must continue tprovide leadership and functional/domain expertise even after completion of the initial requirements development activities. Desired Skills, Abilities, Qualities and Experience SCDHHS is seeking individuals with broad experience in other states or other payers (commercial or government) thelp plant the seeds of innovation in the project. An understanding of national trends and best practices will be valuable tthe project. Experience in one or more of the following areas Healthcare claims processing including professional and institutional claims, dental claims, pharmacy claims, and durable medical equipment claims. Knowledge of Health Insurance Portability and Accountability Act (HIPAA) Electronic Data Interchange (EDI) transactions as well as the impacts of Health Information Technology (HIT) and Electronic Health Record (EHR) legislation is alsdesired. Provider management processes tinclude enrollment, credentialing, verification, outreach, training needs, EHRs, Health Information Exchanges (HIEs). Member/beneficiary management including eligibility determination, enrollment, managed care, education, outreach, and grievances/appeals Experience eliciting and managing requirements on large IT projects. Experience in MMIS or other healthcare claims system(s). Experience in successfully transitioning systems and/or procedures/processes. Experience with business process management (BPM). Experience with software tools; requirements management, configuration management, version control, test management, etc. An understanding of the Medicaid Information Technology Architecture (MITA) Technical computer knowledge Experience with complex modeling techniques Technical writing skills Strong understanding of project management practices, including software development lifecycles, and how tmanage tthe critical path through demonstrated leadership. Excellent teamwork and interpersonal skills. Understanding of how IT affects an organization and how it links tbusiness processes. Excellent analytical skills. Good conceptual skills. Experience with test plans, test matrices, project plans, and scope & design documents. Ability tinfluence and negotiate solutions tbusiness problems. Superb written and oral communications skills. Strong proficiency in English is required. Able tcommunicate effectively with technical and nontechnical audiences, including the ability texpress complex technical and business concepts tmanagement levels, peers, and business units. Impeccable integrity. This is a high visibility project and will impact significant expenditures of public funds. Willingness and ability teffectively engage with people and organizations in a high intensity environment. A bachelors degree in a relevant field.