Please do not reply without the skills “mapping”


Sr. BA - Q/A

4 months Contract

Downtown Minneapolis, MN:



Non-local ok. Phone hire ok.



Could you please 1) give a brief statement and/or 2) list years of
experience with each of the required and desired skills below?



Skill Sets
Needed:


•             Six plus years as a Senior Business Analyst in the health
care claims processing.

•             Must have applicable QA claims health care experience for 2 –
3 years.

•             Experience in working with claims accumulators that cross
apply to medical and pharmacy benefits.

•             Understanding of Medicaid & Medicare benefits is preferred

•             Strong analytical and technical skills

•             Good verbal and written communication

•             Prior experience with back office functions, government
programs and/or the Facets product preferred

•             Experience with the implementation of healthcare operations
software solutions



Business Need




Client’s business will have additional business in place starting
1/1/2016.  The expansion work includes a product implementation that
requires Client to document business requirements for system requests and
system configuration that will need to be implemented by Client’s delegated
vendor.  The business requirements that need to be documented are for new
benefits, claim accumulators (between medical and the PBM), networks,
provider contracts, and enrollment changes.  To support this implementation
Client requires a Senior Business Analyst/Quality Analyst position to
support the documentation of business requirements, documenting the
business acceptance test plan, develop test cases, and develop test
timelines with the Client Project Manager in partnership with the delegated
vendor.



Description of Work to Be Performed and the Specific Skill Sets Needed:





Roles and Responsibilities:



The Senior Business Analyst will provide business analysis and quality
assurance services implementing a new product with Client’s delegated
vendor that is accountable to for claims processing on behalf of lient.
This position would take work direction from the Client Project Manager.



In conjunction with other technical staff on the project team, work could
include:



Business Analysis

•             Build process flows and procedures, review existing
documentation and define the Gaps.  Complete updates to existing
documentation to fill gaps.

•             Document any current operational gaps and incorporate changes
to future operations if applicable

•             Aligning the Integrated project plan with Client and all of
their vendors / partners

•             Develop future state recommendations and vendor/management
oversight toolkit.

•             Research and develop processes for implementation and
oversight.

•             Identify, analyze, document, communicate and validate
requirements for changes to our core and supporting software products and
business processes.

•             Provide support, as necessary, for internal audit and impacts
related to outsourcing Medicaid claims processing.



Quality Assurance

•             Develop test plan with business areas and delegated vendors

•             Develop and execute test cases

•             Create and maintain test data

•             Document test results  and track defects




Skill Sets
Needed:


•             Six plus years as a Senior Business Analyst in the health
care claims processing.

•             Must have applicable QA claims health care experience for 2 –
3 years.

•             Experience in working with claims accumulators that cross
apply to medical and pharmacy benefits.

•             Understanding of Medicaid & Medicare benefits is preferred

•             Strong analytical and technical skills

•             Good verbal and written communication

•             Prior experience with back office functions, government
programs and/or the Facets product preferred

•             Experience with the implementation of healthcare operations
software solutions



List of Deliverables, e.g. what the consultant(s) will be expected to
accomplish: ¬





•             Regular status reports

•             Identification and estimation of BA tasks for the overall
project plan

•             Business requirements

•             Follow issue management process and manage it in cooperation
with project management

•             BA documentation created/utilized in the project

•             Other project documentation, as assigned

•             Active project team member

•             Business Acceptance test plan, test cases, controlled release
plan as we release claim in production

•             Adherence to Client Non-discrimination and Respectful
Workplace policy



Impact/Outcome from a Business Perspective:






Claims are processed correctly for health clients.



Thanks & Regards,
Rani Adari
Tech Tammina
203 Elden Street
Herndon, VA-20170
Call: 703-880-4992
Fax: 703-991-5532
[email protected]
www.tammina.com

GTalk:raniadarii

<http://www.tammina.com/>

*An ISO 9001:2008 Certified Company*

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