Sr Business Analyst With Medicaid Experience

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