I have a very urgent DIRECT CLIENT requirement for *Healthcare Business
Analyst* in *Columbia, SC*. Please Let Me Know If you have available
candidate, please reply with their word resume, location, rate and contact

Please send the resumes at pe...@cncconsulting.com

Job Title: Healthcare Business Analyst
Location: Columbia, SC
Duration: 12 Months

The Eligibility and Enrollment Member Management Project is one of the
largest IT projects for the State of South Carolina. It is a multi-year
effort to replace the State’s aging Medicaid Eligibility Determination
System and other member management applications with a with a multi-tier
application environment that requires modern technologies, technical
practices and substantial collaboration with a variety of stakeholders.
This system will primarily be a commercial-off-the-shelf (COTS) framework
that will be configured/implemented by the State in partnership with
Clemson University. SC uses the social program management platform from IBM
Cứram in the provision of services. This software combines the advantages
of commercial off-the-shelf software, an enterprise platform and
service-oriented architecture with the business and technical flexibility
required to implement solutions to meet agency objectives.

A replacement Eligibility and Enrollment Member Management Project Business
Analyst is responsible for evaluating agency needs, as-is and to-be
business processes, and technical designs to provide analysis and advice on
strategies for information technology solutions and non-technical
solutions. The BA will provide detailed analysis and document business
processes and requirements. The position will conduct and document gap
analysis to determine if the Cứram software meets the business
requirements. The position will assist with user acceptance testing and
identify solutions based on testing results. The position will communicate
concepts for both technical personnel and non-IT business users.

Duties include:
Requirements development execution, including the elicitation, analysis,
specification and validation.
Documenting and analyzing agency business processes and recommending
Documenting and analyzing data requirements and relationships.
Participating in the requirements management processes, including change
control, version control, tracking and status reporting, and traceability.
Providing requirements interpretation and guidance to technical and test
Proactively identifying risks, issues, and action items leading to possible
Interacting with internal and external organizations (i.e. vendors, State
and Federal government agencies, State providers and beneficiaries, and
other stakeholders).
Participating in standup of business operations supporting the Eligibility
and Enrollment Member Management Project.
Planning for, conducting, and reporting on testing and other quality
assurance activities.
Other duties as assigned.
Subject matter areas include member related eligibility determination,
enrollment and disenrollment, eligibility inquiry, program policy, and
state plan. Familiarity with the Affordable Care Act and impacts on
Medicaid eligibility and member related processes is also beneficial.

Strong background and at least four years in social services and/or
healthcare insurance operations (payer or provider side; government or
commercial side).
At least three years of experience in social services and/or healthcare
insurance IT software/systems implementations
Minimum of (3) years of experience in business application consulting,
training or development.
Experience in business process analysis (Use Cases and/or process flows)
and mapping (Gap Analysis) techniques
Ability to properly document business requirements and business rules.
Ability to establish and maintain effective working relationships with
Ability to organize, prioritize and follow complex and detailed procedures
Capable of performing job with minimal supervision
Superb written and oral communication skills, including the ability to give
presentations to executive management. Strong proficiency in English is
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.

Experience in Cứram social program management platform
Medicaid eligibility system/business operations experience
Knowledge and experience with the BizAgi BPM tools
Knowledge of healthcare insurance principles and processes
Medicaid operations experience
Public sector and/or academic environment experience is a plus
Medicaid Management Information System (MMIS) experience

Bachelor’s degree in a technical, business, or related field.

Documentation/Language           Business Process Modeling (BPM)
No          2              Advanced            Within 1 Year     1 - 2
Miscellaneous   Ability to analyze and document, business and system
processes using various methods and tools.          Yes                1
           Expert   Within 6 Months              2 - 4 Years
Miscellaneous   Mapping business process flow Yes         2
 Advanced            Within 1 Year     1 - 2 Years
MMIS - Medicaid Management Informaiton System       Healthcare Insurance IT
software/systems implementations       Yes                1
 Expert   Within 6 Months              2 - 4 Years
MMIS - Medicaid Management Informaiton System       Medicaid eligibility
system/business operations                No          3

Programming Languages              BizAgi BPM Tools              No
Specialties           Business Analysis experience to include data flow
diagrams, requirements specifications, use case scenarios, and acceptance
testing.           Yes         1              Expert   Within 6 Months
 2 - 4 Years
Specialties           Public sector and/or academic environment        No


Peter Smith
Direct: 224-764-8535
Email ID: pe...@cncconsulting.com

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