Senior Business Analyst – MMIS, Medicaid Pharmacy

This is a fully remote position, open to applicants in Illinois, +1 more state.

📋 Description

• Facilitates business, policy, and technical execution across one or more functional areas within MMIS (Medicaid Management Information Systems) and/or the Medicaid Pharmacy sector.

• The Business Analyst collaborates closely with the Domain Lead, Technical Analysts, and cross-functional teams to guarantee successful implementation and operational preparedness.

• Ensures compliance by confirming that solution design and configuration adhere to CMS guidelines, state policies, and established business rules.

• Assists the Executive Lead with in-scope negotiations and change control, providing domain expertise to evaluate scope trade-offs and the functional, regulatory, and operational implications of change requests.

• Leads and participates in collaborative requirements and design sessions with clients and internal teams to confirm functional and technical requirements.

⛳️ Requirements

• Bachelor's degree in Computer Science, Information Systems, Health Informatics, or a related discipline.

• 5 to 8 years of practical experience in supporting healthcare system implementations, particularly MMIS solutions and Medicaid Pharmacy platforms.

• Familiarity with QNXT or other healthcare claims/encounter management systems.

• In-depth knowledge of state and federal Medicaid policies, regulations, and program rules (essential).

• Solid understanding of Medicaid domains, including claims, member, provider, and prior authorization processes.

• Proven experience in translating policy and program rules into system requirements, configuration support, and design documentation.

• Proficient knowledge of SQL is necessary, especially for data analysis and validation.

• Excellent client communication skills, with a background in engaging directly with business stakeholders.

• Demonstrated ability to lead or assist in functional demonstrations, walkthroughs, and collaborative working sessions.

• Strong documentation, facilitation, and analytical abilities.

• Experience in SDLC and Agile delivery methodologies.

🏝️ Benefits

• Generous, flexible vacation policy.

• Educational assistance.

• Comprehensive health benefits.

• 401(k) employer match.

• Leadership and technical development academies.