Business Analyst

Mindlance; Quincy (MA); Hybrid; USD 90,000 - 120,000; Full time

Job summary

Mindlance is recruiting a Business Analyst to support the Massachusetts MMIS program (MassHealth) focusing on Prior Authorizations and provider reimbursement activities. You will lead requirements, design, testing, and implementation, collaborate with project stakeholders and vendors, and ensure compliance with Federal and state rules.

The role requires a BA with healthcare IT experience, SQL/data analysis skills, strong communication and documentation abilities, and the capacity to work in a

Qualifications

• Proficient in business analysis to support all stages of system project lifecycle.
• Competency in HIPAA claims and payment transaction processing.
• Strong data analysis skills; SQL proficient.
• Excellent communication and documentation skills.
• Interpersonal skills to interact with project managers, developers, business analysts and stakeholders.
• Demonstrated ability to work independently, as well as within project teams.
• Highly analytical with the ability to analyze, document findings and recommend solutions.

Responsibilities

• Lead and participate in joint application design sessions with stakeholders.
• Develop test strategies, test scenarios and test cases based on requirements.
• Execute and review test runs and sign off on testing components.
• Document requirements and participate in their development and testing.
• Support the development of end-user training materials and end-user documentation as required.
• Possible oversight during stabilization phase including monitoring and fix strategies.
• Work with vendors to ensure business requirements are defined and tested.
• Communicate updates and changes to impacted stakeholders.
• Represent MMIS in business meetings as needed.
• Support program staff, vendors, and other stakeholders with MMIS questions or concerns.
• Provide back up to other business analysts as needed.
• Data query and analysis.

Skills

Business analysis

SQL data analysis

Communication skills

Documentation

Independent and teamwork

HIPAA knowledge

Stakeholder engagement

Education

Bachelor's degree in Business, IT, or Healthcare administration

Tools

SQL

Job description

Program Overview:

The Massachusetts Executive Office of Health and Human Services (EOHHS) is the largest secretariat in MA state government, comprised of 16 agencies with over 23,000 employees statewide. EOHHS services directly touch the lives of slightly more than one in four residents in the Commonwealth — some of our most vulnerable citizens, including children, youth, adults, and elders. EOHHS provides access to medical and behavioral health care, substance misuse treatment, long term services and support, and nutritional and financial benefits to those with low incomes. We connect elders, individuals with disabilities, and veterans with employment opportunities, housing, and supportive services. We steer troubled youth towards a more successful path and do everything possible to keep children in our child welfare system safe. We support individuals who are developmentally disabled, mentally ill, blind, deaf or hard of hearing.

EOHHS is seeking to hire a Business Analyst- PA Prior Authorizations expertise to join our collaborative Medicaid Management Information System (MMIS) team. The Business Analyst (BA) will work on our established Provider Reimbursement and Claims processing functional areas to support the development, testing and implementation of projects and enhancements to meet the business objectives of the MassHealth (Massachusetts Medicaid) program specifically projects to support the member community. BA should be well versed in health plan management, operational concepts, and the systems development lifecycle. Preference will be given to candidates with Medicaid systems experience well as claims and business knowledge of the MassHealth program.The BA must have sufficient knowledge of the entire scope of the health care business systems and excellent knowledge in the Claims Processing area including PA. Client, and Referrals. to ensure that the development and testing work within their functional area is compatible with the MMIS system. The BA’s primary responsibility is to ensure that the implemented coding scheme meets the requirements of the business community and conforms to all applicable Federal and state laws. The BA will be called upon to act as an active member in all phases of the project including gap analysis, requirements gathering, design and development activities, documentation, testing, implementation, and stabilization. The BA will be expected to work independently, as part of a team as well as with business stakeholders so excellent communication and documentation skills is a requirement for this job. Knowledge of Interoperability and X.12 emerging standards is beneficial. The primary work location for this role will be at 1 ENTERPRISE DRIVE, Quincy, Massachusetts 02171. The work schedule for this position is Monday thru Friday, 9:00AM to 5:00PM. This position is expected to follow a hybrid model of reporting to work that combines in-office workdays and work from home days as needed. Schedules are subject to change based on the operational needs of the business.

DETAILED LIST OF JOB DUTIES AND RESPONSIBLITIES:

• Lead and participate in joint application design session with stakeholders
• Knowledge of SDLC and Agile methodology a plus
• Develop test strategies, test scenarios and test cases based on written requirements
• Execute and review test runs and sign off on testing components
• Document requirements and participate in their development and testing
• Support the development of end-user training materials and end-user documentation as required.
• Possible oversight role during the stabilization phase of each release including the monitoring of system change execution, the development of system “fix” strategies and the close monitoring of the implementation of those strategies
• Work with vendors to ensure business requirements are fully defined and tested.
• Communicate updates and changes to impacted stakeholders
• Represent MMIS in business meetings as needed
• Support program staff, vendors, and other stakeholder with MMIS related questions or concerns.
• Provide back up to other business analysts as needed.
• Data query and analysis.

Preferred Qualifications:

• Proficient in business analysis to support all stages of system project lifecycle
• Competency in HIPAA claims and payment transaction processing
• Strong data analysis skills- SQL proficient
• Excellent communication and documentation skill
• Excellent interpersonal skills necessary to interact effectively with project managers, developers, business analysts, systems analysts, SQA analysts, business users/stakeholders, and data processing personnel; as well as interact with representatives from external agencies and companies.
• Demonstrated ability to work independently, as well as within project teams, providing relevant system analysis services.
• Highly analytical, with the ability to independently analyze, document findings and recommend solutions.

Education and Certifications:

• Bachelor’s degree or higher in Business, IT or Healthcare administration with minimum 3 years’ experience, or equivalent in healthcare administration setting

EEO:- Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans