*Healthcare Business Aanalyst - Direct Client **Immediate Interview and Start ASAP!!!*
*Please send resume to [email protected] <[email protected]> * *Job Title: Healthcare Business AanalystLocation: Columbia, SCDuration: 12 MonthsDirect Client Position The Business Analyst will work with various internal teams including Program Management/Project Managers, and other SMEs to evaluate Healthy Connections Prime business requirements. Provides technical designs to provide analysis and advice on strategies for information technology solutions and non-technical solutions. The majority of system development work will be outsourced to vendors and/or other state organizations.We are looking for candidates who are highly organized, can work independently in a fast-paced environment and produce multiple quality deliverables with varying deadlines. Candidates should be self-starters and creative problem solvers and have the flexibility to learn new products and technologies quickly.Subject matter areas include: Provider Management, Member (beneficiary) management/eligibility, Claims editing and pricing (professional, institutional, pharmacy, dental, durable medical equipment, transportation, etc.), Claims Payment and State budget assignment, Financial Management, Provider re-imbursement methodology, third party liability, drug rebate, prior authorization, managed care, behavioral health, long-term care, program integrity, electronic health records, benefit plan administration, etc.Familiarity with X12 EDI transactions is also beneficial.REQUIRED SKILLS/KNOWLEDGE:Finance experience required on Project planning and financial budgetingTraining and experience in financial analysis and assessment; Experience in the financial analysis of large health data systems; Experience in government Medicaid financial reporting;Experience in state Medicaid MARS/SURS financial analysis and reporting; Strong background and at least six years experience in healthcare insurance business operations (payer or provider side; government or commercial side). Note: IT operations are not the same as business operations.At least four 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 create/interpret business process and business data models.Vendor management experience 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.Agile, waterfall, SDLC, PLCRequirements gathering experience.PREFERRED SKILLS:Understanding of the Medicaid Information Technology Architecture (MITA).Understanding of the Medicaid Enterprise Certification Toolkit (MECT).Experience with traditional Medicare or Medicare AdvantageExperience in an outsourced healthcare insurance operations environment.Experience on an outsourced IT development project.PUBLIC SECTOR/GOV’T EXPERIENCE REQUIRED?Not required, but preferred. Please send resume to [email protected] <[email protected]> * *Thanks, Sam CNC Consulting, Inc. 201-546-3096 [email protected] <[email protected]>* -- You received this message because you are subscribed to the Google Groups "Open Source J2EE frameworks" group. To unsubscribe from this group and stop receiving emails from it, send an email to [email protected]. To post to this group, send email to [email protected]. Visit this group at http://groups.google.com/group/open-source-j2ee-frameworks. For more options, visit https://groups.google.com/d/optout.
