Senior Business Analysis Engineer – Medicaid

This is a fully remote position, open to applicants in United States.

📋 Description

• Collaborate with business stakeholders to collect, analyze, and document business and system requirements.

• Examine suspended claims, operational challenges, and system defects to determine root causes and propose solutions.

• Work in partnership with development and QA teams to design, test, and validate system enhancements and operational improvements.

• Review updates to Medicaid policies, CMS mandates, and client directives to evaluate their impact on business processes and system functionality.

• Investigate billing manuals, design documentation, and regulatory guidance to aid in issue resolution and decision-making.

• Document and enhance business processes to boost operational efficiency and effectiveness.

• Act as a liaison between business and technical teams throughout the project lifecycle.

• Create test strategies, scenarios, and plans to validate state policy requirements and payment methodologies.

• Assist in UAT activities and facilitate the implementation of system changes.

• Analyze data and trends to deliver actionable insights and support operational reporting requirements.

⛳️ Requirements

• Experience in interpreting and applying Medicaid policies, CMS regulations, and state healthcare program requirements.

• In-depth knowledge of Medicaid claims processing and payment systems.

• Capacity to comprehend and apply Medicaid payment methodologies in business analysis and testing activities.

• Strong analytical, troubleshooting, and problem-solving capabilities.

• Ability to independently research and assess documentation, policies, billing manuals, and technical specifications.

• Excellent communication and collaboration skills with both business and technical stakeholders.

• Proficient in managing multiple priorities in a dynamic environment.

• Over 8 years of experience in the healthcare industry, preferably within the MMIS domain.

• Demonstrated experience supporting large-scale Medicaid systems and operational processes.

• Familiarity with SQL and relational database concepts.

• Strong presentation, facilitation, and organizational abilities.

• Proficiency in Microsoft Office applications, including Outlook, Word, and Excel.

• Exceptional written and verbal communication skills with a focus on customer service.

• Capability to work independently while driving initiatives from analysis to implementation.

🏝️ Benefits

• Comprehensive health and welfare benefits tailored to the needs of employees and their families, starting on the first day of employment.

• Retirement savings plan.

• Opportunities for career advancement.

• Paid time off packages.

• Health insurance coverage.

• Voluntary dental and vision programs.

• Life and disability insurance.

• Paid holidays.

• PTO or vacation and/or sick time.

• Option for remote work from home.

• Award-winning workplace culture and a diversity-focused environment.

• Eligibility for bonuses or incentives based on business needs.