Hi , Greetings…!!! * *
*Please send resume to [email protected] or contact 703-348-2872* This is *Ron Sally* from *Elegant Enterprise-Wide Solutions, Inc.*(company founded in 2001); we are a IT consulting and staff augmentation firm working hand in gloves with government (federal, state, county) and lot of commercial clients directly. Our success is result of our philosophy of sharing most of bill rate with consultants so that people who make it happen get most of it. We have a job position and have really liked your resume for this position and feel that you will be a great match and an asset if hired. Please review below the full job and let me know if interested. ** *Position: Business Analyst* *Position ID: 5051* *Duration: 12 Months * *Location: Columbia, SC* *Client: State of SC- Department of Health and Human Services* *Required Skills* · *General* *Medicaid *or *Medicare* Experience Required. · Strong background and proven experience in healthcare insurance * business* 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 one year 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. · Superb written and oral communications 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 *Desired / Proffered Skill * · Understanding of the Medicaid Information Technology Architecture (MITA). · Understanding of the Medicaid Enterprise Certification Toolkit (MECT). · Vendor management experience. · Experience in an outsourced healthcare insurance operations environment. · Experience on an outsourced IT development project. · Experience in creating business process and business data models. · Public sector procurement experience is a plus *Responsibilities:* A Replacement MMIS Subject Matter Expert (SME) is responsible for evaluating agency needs, as-is and to-be business processes, and solution 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 outsourced to vendors and other State organizations. · 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. · Participate in the requirements management processes, including change control; version control; tracking and status reporting; and traceability. · Providing requirement 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). - Planning for, conducting, and reporting on testing and other quality assurance activities. - Other related activities. Subject matter areas include: provider management, member (beneficiary) management/eligibility, claims (professional, institutional, pharmacy, dental, durable medical equipment, transportation, etc.), third party liability, financial management, reimbursement methodology, drug rebate, prior authorization, managed care, behavioral health, long-term care, program integrity, electronic health records, benefit plan administration, etc. Familiarity with ICD-9/ICD-10 coding standards, X12 EDI transactions, and the Affordable Care Act and it impacts on Medicaid eligibility and health insurance exchanges is also beneficial. *Required Education:* · Bachelor’s degree. *If interested, Please send your updated resume with rate expected for this position along with the following details ASAP.* Full Legal Name (As per SSN): Location: Contact: Email: Availability: Ready for Relocation: 2 Professional References Rate: Visa Status ( H1B/EAD/GC,US Citizen): Year and Month of Under graduate degree with Major( B Tech in Computer Science ,B.S Computer Science etc.) : Year and Month of Graduate degree with major( MCA,MS in Computer Science, MSc in Computer Science etc.) : For verification purposes, a copy of the work Visa and degrees of the candidate will be required for H1B/EAD/OPT candidates. *Client prefers Skype interviews. 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