Functional Consultant

CAYS Inc; City of Albany (NY); Presencial; USD 110 000 - 150 000; Tempo integral

Resumo da oferta

CAYS Inc in Albany, NY seeks a Functional Consultant to support Medicaid programs and healthcare projects. You will collaborate with State agencies, MCOs, and vendors to analyze requirements, document BRDs/FRDs, and guide testing through UAT and defect resolution.

Candidates should have HIPAA 834/278 experience, strong SQL/data analysis skills, and proficiency with JIRA, Confluence, Visio, and MS Office. This is a long-term, on-site role in Albany, NY.

Qualificações

• Experience as functional/business analyst or consultant in healthcare, Medicaid, or government programs.
• Excellent stakeholder management and communication with State agencies, MCOs, and vendors.
• Strong understanding of Medicaid operations, LTSS, and enrollment processes.
• Experience with HIPAA 834 and/or 278 transaction sets and implementation guides.
• Experience creating BRDs/FRDs, workflow diagrams, data mapping specs, and interface docs.
• Supporting development and testing teams through clarification, UAT, issue resolution, and defect mgmt.
• Proficiency with JIRA, Confluence, Visio, and MS Office.
• Experience supporting HIPAA 834 Enrollment and HIPAA 278 Authorization transactions.
• Familiarity with MLTC enrollment workflows and non-MAGI eligibility.
• Working knowledge of SQL and data analysis for reconciliation and root-cause investigation.

Conhecimentos

Healthcare domain

Stakeholder management

HIPAA 834/278

BRD/FRD/docs

UAT/Defect mgmt

SQL/Data analysis

Ferramentas

JIRA

Confluence

Visio

MS Office

Descrição da oferta de emprego

Role: Functional Consultant

Location: Albany, NY

Duration: Long term

Required Skills/ Qualifications

• Experience as a Functional Analyst, Business Analyst, or Consultant within healthcare, Medicaid, or government-sponsored programs.
• Excellent stakeholder management and communication skills with the ability to collaborate effectively with State agencies, Managed Care Organizations (MCOs), and third-party vendors.
• Strong understanding of Medicaid operations, LTSS programs, member enrollment processes, and managed care environments.
• Practical experience working with HIPAA 834 and/or 278 transaction sets, including transaction structures, loops, segments, code values, and implementation guides.
• Experience creating business and functional requirements documents (BRDs/FRDs), workflow diagrams, data mapping specifications, and interface documentation.
• Proven experience supporting development and testing teams through requirements clarification, UAT, issue resolution, and defect management.
• Proficiency with project and documentation tools such as JIRA, Confluence, Visio, and Microsoft Office Suite.
• Experience supporting both HIPAA 834 Enrollment and HIPAA 278 Authorization transactions.
• Familiarity with Managed Long-Term Care (MLTC) enrollment workflows and non-MAGI eligibility processes.
• Working knowledge of SQL and data analysis techniques for reconciliation, validation, and root-cause investigation.