Sr. Business Analyst (Medicaid)
Albany, NY [Must be able/willing to be onsite 50% of the time every week at the client site].
Overview of job:
The Senior Business Analyst will support the client's contractors with obtaining CMS certification of the Medicaid Enterprise Systems (MES). As the various MES components become operational, successful completion of the CMS Federal certification process of the MES will require the evaluation and validation of the subsystems to ensure attainment of CMS certification for the client to continue to receive Federal Financial Participation (FFP). The QA Business Analyst must be aware of any new or upcoming changes to the CMS certification process and be prepared to assist the client and its contractors in achieving certification in accordance with current and any revised CMS guidelines.
Job Responsibilities Include:
Review, evaluate and validate mandatory MES systems and subsystems to determine compliance with core CMS Federal certification requirements
Coordinate certification activities with client's contractors and staff
Establish checklists for CMS onsite visits
Attend meetings with client and CMS staff. Prepare agenda, meeting notes, decision lists and follow up action items
Support of CMS Federal certification review team/CMS Regional Office staff briefings and pre-certification meetings and calls
Assist with preparations for CMS on-site visits
Analyze data, reports, and deliverables, as needed
Assist with resolution of any CMS Federal certification issues
Review of CMS Federal certification report(s) and provide additional guidance to Department and its Contractors
Support the preparation of Department responses to CMS
Ensure all current and future CMS policies and requirements are met for system testing and attestations, as required
Track T-MSIS compliance, and report any issues, risks, and mitigation plans in QA status reports and proactively notify the client of any concerns
Review all the Federal rules governing the T-MSIS data submission and provide actionable plans to the Department to ensure that the compliance status is maintained
Required Qualifications:
Minimum eight (8) years of experience fostering strong working, business partnering relationships and communication with clients, key internal and external stakeholders and executive staff; ensuring teams are aware of CMS policies
Minimum three (3) years of experience implementing the CMS certification process on Medicaid programs with deep understanding of CMS policies and how they impact systems
Minimum five years of experience managing requirements
Minimum five years of experience preparing Business Process Design documentation using BPMN 2.0 and related models
Minimum five years of experience working with teams of five or more staff
Minimum five years of experience with business process models and/or use cases
Bachelor's degree in information technology, Business Administration or similar field
This position requires 50% onsite, so local candidates required.
Preferred Skills:
Eight years of experience in IT business analysis, testing, project management, or QA services
PMI PBA, CBAP, or equivalent certification
Certifications in Lean Six Sigma, Agile, PDCA, or Kanban
Three (3) years of experience with highly integrated, large-scale integrated Medicaid systems
Two years of experience in a healthcare or insurance domain
