Business Analyst

Job Description

Assists in analysing and documenting client's business requirements and processes; Communicates these requirements to technical personnel by constructing configuration deliverables Adheres to and supports Configuration team approach and other configuration principles, methodologies, and practices Analyses configuration data and structure to isolate defects Experience with Configuration Implementation Build & Maintenance Research and define solutions for new configuration, legislation, or client rules. Experience configuring in QNXT or FACETS Understands Medicaid Program structure in carriers, programs, benefit plans, policy, policy plans, sponsor, and or policies. Understands Provider (Contract and Pricing) data Understands Member data including but not limited to aid categories, coverage codes, benefit packages, restrictions, limitations, prior authorizations, programs, and primary care providers. Experience with Configuration Implementation Build & Maintenance Understands relational database concepts and schemas Experience writing SQL queries for data analysis Experience processing Medicaid claims and ability to troubleshoot adjudication results Assists in creating basic test scenarios to verify that client requirements are incorporated into the system design. Assists in developing and modifying systems requirements documentation to meet client needs. Participates in meetings with clients to gather and document requirements and explore potential solutions. Business analysis experience in U.S. Medicaid management preferred