*Please submit resumes to go...@metasenseusa.com *
*face to face** after phone interview. No expenses paid.***
*Location: Boston, MA*
*Duration: 3-6+ months*
*Rate: $45 per hour Max.*
*Title/Role: Business Analyst. *
*The following are two items that the candidate MUST have a lot of
- *Claims and Adjudication*
- *Medicare and Medicaid*
*Project:* Implementation of a dual eligible product. This involves
members who are eligible for both *Medicare and Medicaid*. The project is
complex and includes designing a new Care Model, identifying new IT tools to
support the new Care Model, defining the requirements for operational units
(enrollment, claims, customer service, sales & marketing) and working with
both CMS (for Medicare) and Commonwealth of Mass (for Medicaid) to identify
regulatory and operational requirements.
*Role:* The business analyst will be working with multiple business units
and the project team to identify the operational processing requirements for
this new product. The work will include detailed documentation of current
state, work with other analysts to understand new processing requirements,
analysis of existing system (Diamond) and analysis to determine operational
impact of implementing the required new processes. The individual would
need to coordinate with other project teams, the IT PM and the senior
project manager who is coordinating all areas. Familiarity with Medicare
Advantage and Medicaid would be helpful.
- Strong analytical skills including the ability to work with both
operational and technical resources.
- Detailed knowledge of the claims adjudication process within a
healthcare payer or provider environment
- Excellent documentation abilities to capture both current state and new
requirements. Ability with MS VISIO and other documentation tools.
- Requires ability to work with project management techniques, tools and
methods and the use of MSProject and MSOffice suite of products
- Experience with operational processes in a managed care environment.
This includes enrollment, claims processing and customer service.
- Requires well-developed verbal and written communication skills, and
strong facilitation skills.
Highly skilled Analysts with a minimum of 5 years experience in developing
requirements in a *managed care or other health care environment. *
*Thanks & Regards,*
*NJ Minority Certified Company*
100 Technology Way, Suite 320
Mt. Laurel, NJ 08054
Fax: (856) 475-0555
MetaSense Inc. is a Professional Services, Staff Augmentation, Web Design,
Call Center, BPO Company with offices located in Mt. Laurel, NJ. MetaSense
specializes in the delivery of cost effective, high-value Information
Technology and Business Solutions since its inception in 1999.
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