Sr. Medicaid TPL Business Analyst-Local Candidates To Little Rock, AR Job Details | NTT DATA Services

NTT DATA is hiring a Senior Business Analyst to support Business Operations Support for a state Medicaid program. The role focuses on Medicaid Third Party Liability claims, recovery operations, and system and process changes, including requirements, testing, implementation, and evaluation.

Responsibilities:

• Analyze Medicaid claims, TPL workflows, Medicare Crossovers (Pt A&B), Medicare Advantage (Pt C), and recovery data to identify trends, root causes, and opportunities for cost avoidance and recovery optimization
• Translate federal/state TPL policies into system requirements
• Support MMIS enhancements, including adjudication rules and edits, reporting, letters, etc
• Work with vendors and state stakeholders to improve all faucets of insurance discovery and recovery processes
• Lead requirements gathering, documentation, create and conduct UAT testing
• Identify and report issues, risks, and dependencies
• Support issue triage, backlog management, and operational reporting for day-to-day TPL activities

Requirements:

• Minimum 6 years of experience supporting large, complex Medicaid system implementation projects and/or Medicaid business operations
• Minimum 6 years of experience with TPL, Coordination of Benefits, Medicare Crossover Part (A&B) Claims processing, Medicare Advantage (Part C), claims workflows, including complex claim scenarios and regulatory compliance
• Minimum 6 years of experience with elicitation and verification of business and technical requirements
• Minimum 3 years of experience with system development methodology and project management principles
• Minimum 3 years of experience conducting reviews of system development life cycle documentation, project and technical architecture and design deliverables/artifacts
• Undergraduate degree or 4 years relevant experience
• Experience translating Federal and State regulations into working requirements that are actionable by technical teams
• Experience working with Medicaid Enterprise Systems (MES) vendors
• Ability to translate between non-technical business users and technical IT resources
• Strong SQL and data analysis skills
• Strong understanding of HIPAA and X12 EDI standards