Medicaid Business Analyst

GetInsured is a leader in transforming government IT infrastructure with proven SaaS and AI technology, particularly in health insurance. The Medicaid Business Analyst is responsible for ensuring the integrity of Account Transfer XML data exchanges between the State Exchange and the Medicaid Management Information System, performing gap analysis, defining field-level mapping, and coordinating with Medicaid partners to ensure seamless data flow.

Responsibilities:

• Review and analyze Account Transfer XML files to identify data discrepancies, structural gaps, or missing fields between the Exchange and Medicaid systems
• Troubleshoot and resolve production data issues related to failed or "stuck" account transfers
• Lead the coordination with Medicaid stakeholders to define and maintain Source-to-Target Mapping (STTM) documents for all shared data elements
• Maintain a centralized repository of agreed-upon mapping logic, data dictionaries, and transformation rules
• Act as the primary point of contact for Medicaid agencies, conducting regular "pulse checks" to monitor system-to-system traffic health
• Report on transmission success rates and proactively identify trends in data rejection or service interruptions
• Support System Integration Testing (SIT) and User Acceptance Testing (UAT) by developing test cases specifically for data mapping and XML validation
• Verify that incoming data correctly triggers the intended enrollment actions in the target system

Requirements:

• Proficiency in reading and validating XML/XSD
• Strong SQL skills for data reconciliation
• Experience with EDI or health data standards (HL7/NIEM)
• 3-5+ years in Medicaid, Healthcare IT, or Insurance Exchange environments with a focus on data integration
• Proven experience in Gap Analysis and complex data mapping
• Strong ability to translate technical XML issues into business impacts for Medicaid stakeholders and vice versa