|Title:||Lead Business Analyst|
|Location:||Columbia, SC 29201|
SCOPE OF THE PROJECT:
The Replacement MMIS project is among the most complex ITprojects taken on by the State’s Department of Health and Human Services. Thisproject is a multi-year effort to replace many of the State’s aging Medicaidsystems with modern technologies and supporting business operations.
OBJECTIVES TO BE FULFILLED BY CANDIDATE:
The principal duties of this position are to develop andmaintain business requirements with associated artifacts such as requirementsplans, process flows, and other models as needed.
Daily work will concentrate on these work streams:
• Member, Provider, Claims, Prior Authorization and Finance
These work streams will support the following modules forRMMIS:
• Business Intelligence System
• Administrative Services Organization (ASO) for Fee forService (FFS) claims
• Pharmacy Benefits Administrator (PBA)
• Dental Administrative Services Organization (DASO)
• Accounting and Finance
• Third Party Liability (TPL)
• System Integration and Operations (SIOPS)
• Technology Framework (Integration Hub, Portal andEnterprise Data Services)
• RMMIS Program Management
Specific duties include, but are not limited to:
• Plan, elicit, capture, analyze and validate business, functionaland technical requirements.
• Facilitate requirements elicitation sessions andwalkthroughs with business and IT resources.
• Collaborate with departments to identify, document andcommunicate business needs and provide
• Develop business rules via interviews, translation ofgoverning documents and other means.
• Conduct JAD Sessions with Product Owners
• Partner with business owners on requirements developmentand project collaboration
• Assist other team members in performing business rules,requirements, and modeling duties.
• Research business rules, requirements, and models.
• Use case development
• Requirements traceability
• 8+ years’ experience in government IT projects as abusiness analyst or related duties
• 6+ years’ experience eliciting, mining, and documentingbusiness rules
• General Subject Matter Expertise as it relates to Medicaidor other healthcare insurance experience (project
• Firm understanding of health care payer business process
• Strong understanding of business modeling techniques
• Integrated healthcare delivery from member enrollmentthough to claims payment
• Business operations experience in member enrollment thoughto claims payment
• Ability to effectively communicate to executivemanagement, line management, project management, and
• Experience and ability to obtain business rules andrequirements information by interviewing business
personnel and by mining laws, regulations, and policydocuments.
• Superb written and oral communications skills, includingthe ability to write requirements and Use Cases.
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