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Business Requirements BusinessProcess Modeling Analyst
(Jobs in Columbia, SC)
 
Requirement id 9560
Job title Analyst
Job location in Columbia, SC
Skills required Health Insurance Experience, Healthcare Insurance Business Operations, Healthcare Insurance IT Software, Business Requirements BusinessProcess Mo
Open Date 13-Apr-2012
Close Date
Job type Contract
Duration 12 Months
Compensation DOE
Status requirement ---
Job interview type Phone Screen and Face to Face interview
   Email Recruiter: coolsoft
Job Description Analyst: Health Insurance Experience, Healthcare Insurance Business Operations, Healthcare Insurance IT Software, Business Requirements BusinessProcess Mo

[Note : START DATE : May 2012]

[Note : DURATION : 12 months]

Description :

DAILY DUTIES / RESPONSIBILITIES:
A replacement Eligibility and Enrollment Member Management Project Subject Matter Expert (SME) is responsible for evaluating agency needs, as-is and to-be business processes, and technical designs to provide analysis and advice on strategies for information technology solutions and non-technical solutions. The majority of the system development work will be performed by Clemson University.

Duties include:

? Requirements development execution, including the elicitation, analysis, specification and validation.
? Documenting and analyzing agency business processes and recommending improvements.
? Documenting and analyzing data requirements and relationships.
? Participating in the requirements management processes, including change control, version control, tracking and status reporting, and traceability.
? Providing requirements interpretation and guidance to technical and test teams.
? Proactively identifying risks, issues, and action items leading to possible solutions.
? Interacting with internal and external organizations (i.e. vendors, State and Federal government agencies, State providers and beneficiaries, and other stakeholders).
? Participating in standup of business operations supporting the Replacement Member Management Project.
? Planning for, conducting, and reporting on testing and other quality assurance activities.
? Other duties as assigned.
Subject matter areas include member related eligibility determination, enrollment and disenrollment, eligibility inquiry, capitation premium payment, health insurance premium payment, Medicare premium payment, premium invoice, program policy, and state plan. Familiarity with the Affordable Care Act and impacts on Medicaid eligibility and member related processes is also beneficial.

REQUIRED SKILLS (RANK IN ORDER OF IMPORTANCE):
? Strong background and at least six years in healthcare insurance operations (payer or provider side; government or commercial side). Experience in multiple business areas is a plus. Note: IT operations are not the same as business operations.
? At least three years experience in healthcare insurance IT software/systems implementations performing duties described in the “Daily Duties/Responsibilities” section above.
? Ability to properly document business requirements.
? Ability to interpret business process and business data models.
? Vendor management experience.
? Superb written and oral communication skills, including the ability to give presentations to executive management. Strong proficiency in English is required.
? Impeccable integrity. This project will have very high visibility and will impact significant expenditures of public funds. Candidates must be confident with their abilities to make correct decisions and the courage to speak out when necessary.
? Willingness and ability to effectively engage with people and organizations on a continuous basis.

PREFERRED SKILLS (RANK IN ORDER OF IMPORTANCE):
? Understanding of the Medicaid Information Technology Architecture (MITA)
? Understanding of the Medicaid Enterprise Certification Toolkit (MECT)
? Experience in an outsourced IT development project.
? Experience in creating business process and business data models.
? Public sector procurement experience is a plus.

REQUIRED EDUCATION:
Bachelor Degree or equivalent experience.
 
Call 502-379-4456 Ext 100 for more details. Please provide Requirement id: 9560 while calling.
 
Other jobs in SC: Beaufort (1), Blythewod (2), Blythewood (3), Charleston (17), Columbia (37), Greenville (4), Hartsville (2), North Charleston (2), Overland Park (1), San Francisco (1), SENECA (4), South Carolina (1), Spartanburg (3), Unknown (2),
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(Analyst: Health Insurance Experience, Healthcare Insurance Business Operations, Healthcare Insurance IT Software, Business Requirements BusinessProcess Mo in Columbia, SC)
   
 
     
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