Senior Business Analyst – Medicaid Provider Enrollment Modernization

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

📋 Description

• Assist in modernizing the Medicaid provider enrollment process.

• Organize discovery sessions with stakeholders including Medicaid policy, provider enrollment, operations, technical, security, and vendors.

• Evaluate existing provider enrollment processes, workflows, business rules, system interfaces, forms, notifications, and operational challenges.

• Gather, document, validate, and maintain business, functional, nonfunctional, data, and integration requirements.

• Convert business needs into user stories, use cases, process flows, business rules, requirements traceability documentation, and acceptance criteria.

• Establish requirements for a provider-facing enrollment portal that facilitates application initiation, saving, submission, document uploads, and status tracking.

• Document workflows, page flows, data requirements, user roles, and navigation needs in collaboration with UI/UX and development teams.

• Assist with authentication, role-based access, accessibility, security, and enterprise identity-management integration requirements.

• Analyze and document enhancements to OnBase workflows for provider screening, licensing validation, risk assignment, notifications, site visits, fraud indicators, status changes, and work-queue automation.

• Define data mappings, interface requirements, ingestion rules, validation rules, exception handling, and two-way data exchanges among OnBase, MMIS, portal, and integration teams.

• Examine provider enrollment data related to NPIs, taxonomy, licenses, affiliations, revalidation, ownership, group and individual relationships, and ordering/referring/prescribing providers.

• Identify opportunities to streamline manual processing, enhance data quality, increase workflow visibility, and automate enrollment activities.

• Coordinate with stakeholders to clarify requirements, address gaps, manage changes, and evaluate downstream impacts.

• Review system designs and technical documents to ensure alignment with approved requirements.

• Participate in sprint planning, backlog refinement, demonstrations, defect reviews, and other Agile activities.

• Create test scenarios and expected outcomes based on approved requirements and business rules.

• Assist with system integration testing, user acceptance testing, regression testing, defect triage, and functionality validation.

• Maintain requirements traceability throughout design, development, testing, and implementation phases.

• Prepare status updates, meeting notes, decision logs, risk and issue documentation, and other project artifacts.

⛳️ Requirements

• A minimum of seven years of experience as a Business Analyst supporting complex IT or systems modernization projects.

• Proven experience in eliciting, documenting, validating, and managing detailed business and functional requirements.

• Experience in developing process flows, user stories, use cases, business rules, data requirements, acceptance criteria, and requirements traceability matrices.

• Experience collaborating with business stakeholders, developers, architects, testers, operations teams, and third-party vendors.

• Knowledge of analyzing system interfaces, data exchanges, workflow automation, and cross-system dependencies.

• Experience supporting system development, integration, testing, defect resolution, and implementation activities.

• Excellent facilitation, analytical, problem-solving, documentation, and communication skills, both written and verbal.

• Ability to translate complex policy and operational needs into clear, actionable requirements for technical teams.

• Capability to manage multiple workstreams, priorities, and stakeholders in a complex project setting.

• Experience working in Agile or hybrid Agile delivery environments.

• Bachelor's degree in business, information systems, healthcare administration, computer science, or a related field.

• Relevant professional experience may be considered as a substitute for a degree.

• Preferred: experience with Medicaid, healthcare, or other health and human services programs.

• Preferred: knowledge of Medicaid provider enrollment, screening, revalidation, licensing, affiliations, sanctions, exclusions, ownership, and provider data management.

• Preferred: experience supporting an MMIS or another large public-sector healthcare system.

• Preferred: experience with OnBase workflows, document management, work queues, e-forms, or related automation capabilities.

• Preferred: experience supporting provider-facing portals or online application systems.

• Preferred: experience defining requirements for APIs, system interfaces, data ingestion, data validation, and bidirectional integrations.

• Preferred: familiarity with NPPES, LEIE, and SAM.gov.

• Preferred: knowledge of National Provider Identifiers, provider taxonomy, ordering/referring/prescribing requirements, and provider affiliation structures.

• Preferred: experience with identity-management technologies such as Okta, SAML, or equivalent authentication solutions.

• Preferred: familiarity with ADA and WCAG accessibility standards.

• Preferred: experience in state government or federally funded systems modernization projects.

• Preferred: experience with Jira, Azure DevOps, Confluence, Visio, or comparable requirements and process modeling tools.

• Business analysis or Agile certification such as CBAP, CCBA, PMI-PBA, Certified Scrum Product Owner, or equivalent is preferred.

🏝️ Benefits

• Medical / Dental / Vision Insurance – assistance with insurance premiums provided.

• Additional insurance options (Life, Disability, etc.).

• Paid Time Off.

• 401(k) Retirement Savings Plan & Health Savings Account.

• Various training courses aimed at promoting continuous learning.

• Corporate Wellness Program.

• An employee-centric culture that emphasizes family and a healthy work-life balance.

• Exposure to innovative projects and in-house skill development training/courses.

• Fortune Fund nonprofit initiatives that support education and career awareness in rural communities.