*HI Partners,*

*Please share your consultant matching profile at Rajesh@tekinspirations*
*.com*



*Job Title: Business Analyst - Consultant*

*Location: Columbia, SC*

*Duration: 1yr*

*MOI: Phone*







*Job Description:*


The principal duties of this position are to develop and maintain business
requirements with associated artifacts such as requirements plans, process
flows, and other models as needed.

Daily work will concentrate on these work streams:

·  Member

·  Provider

·  Claims

·  Prior Authorization

·  Finance


These work streams will support the following modules for RMMIS:

·  Business Intelligence System

·  Administrative Services Organization (ASO) for Fee for Service (FFS)
claims

·  Pharmacy Benefits Administrator (PBA)

·  Dental Administrative Services Organization (DASO)

·  Accounting and Finance

·  Third Party Liability (TPL)

·  System Integration and Operations (SIOPS)

·  Technology Framework (Integration Hub, Portal and Enterprise Data
Services)

·  RMMIS Program Management


Specific duties include, but are not limited to:

·  Plan, elicit, capture, analyze and validate business, functional and
technical requirements.

·  Facilitate requirements elicitation sessions and walkthroughs with
business and IT resources.

·  Collaborate with departments to identify, document and communicate
business needs and provide solutions.

*Required Skills:*

·  8+ years’ experience in government IT projects as a business analyst or
related duties

·  6+ years’ experience eliciting, mining, and documenting business rules

·  General Subject Matter Expertise as it relates to Medicaid or other
healthcare insurance experience (project or operations)

·  Firm understanding of health care payer business process

·  Strong understanding of business modeling techniques

·  Integrated healthcare delivery from member enrollment though to claims
payment

·  Business operations experience in member enrollment though to claims
payment

·  Commercial and Medicaid experience preferable

·  Ability to effectively communicate to executive management, line
management, project management, and team members.

·  Experience and ability to obtain business rules and requirements
information by interviewing business personnel and by mining laws,
regulations, and policy documents.

·  Superb written and oral communications skills, including the ability to
write requirements and Use Cases. Very Strong proficiency in English is
required

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


*Preferred Qualifications:*

·  MMIS experience (project or operations)

·  Ability to write and understand business and functional requirements

·  Strong knowledge of formal business rules methodologies





-- 

*Regards,*


*Rajesh Kumar*

*[image: Techlogo]*

*Sr. Technical Recruiter*

*TEK Inspirations LLC*

Cowboys PKWY, #3074, Irving, TX 75063

E: raj...@tekinspirations.com <s...@tekinspirations.com>

W: www.tekinspirations.com

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