Healthcare Business Analyst / Systems Analyst

Computer Task Group, Inc; United States; Remote; USD 55,000 - 69,000; Full time

Job summary

CTG is seeking a Healthcare Business Analyst / Systems Analyst for a remote, 10-month engagement. The role focuses on Medicaid claims processing, provider enrollment, and HIPAA EDI transactions, with strong emphasis on eliciting and translating business needs into system requirements using IBM ELM and ServiceNow.

The candidate will evaluate CA-MMIS data, support CPT/ICD/HCPCS code maintenance, and facilitate JAR sessions, with the goal of aligning business objectives to technical solutions.

Qualifications

• Experience analyzing Medicaid and claims processing requirements.
• Knowledge of HIPAA, EDI X12 transactions, and healthcare eligibility.
• Proficient in documenting requirements and modeling business processes.
• Experience with IBM ELM and ServiceNow.
• Ability to translate regulatory needs into system requirements.

Responsibilities

• Analyze healthcare business and system requirements related to claims processing and Medicaid operations.
• Elicit and translate requirements into HLRs/DBRs, rules, user stories, and acceptance criteria.
• Analyze HIPAA EDI X12 transactions (837, 835, 270, 271, 276, 277).
• Assess CA-MMIS mainframe tables, files, and policy updates.
• Serve as liaison between DHCS and technical teams; facilitate JAR sessions and current/future state models.
• Identify and resolve gaps to align business objectives with solutions.

Skills

Healthcare business analysis

HIPAA regulations & EDI X12

Documentation & requirements

IBM ELM & ServiceNow

Stakeholder communication

Education

Bachelor's degree in IS/CS/Healthcare Admin/Business Admin

Tools

ServiceNow

IBM Engineering Lifecycle Management (ELM)

Job description

CTG is seeking to fill a Healthcare Business Analyst / Systems Analyst position for our client.

Location: Remote Duration: 10 months

Duties:

• Analyze healthcare business and system requirements related to claims processing, provider enrollment, eligibility, and Medicaid program operations.
• Conduct CA-MMIS OIL analysis, requirements assessments, and effort estimations.
• Elicit, document, validate, and translate business needs into High-Level Requirements (HLRs), Detailed Business Requirements (DBRs), business rules, user stories, and acceptance criteria using IBM ELM and ServiceNow.
• Analyze HIPAA EDI X12 transactions, including 837 I/P, 835, 270, 271, 276, and 277.
• Assess CA-MMIS mainframe tables, files, policy updates, and related system impacts.
• Support CPT, ICD, and HCPCS code maintenance.
• Serve as a liaison between DHCS and technical teams to clarify requirements and facilitate solution development.
• Facilitate Joint Application Requirements (JAR) sessions, policy and regulatory impact analysis, and current-state/future-state business process modeling.
• Identify and resolve requirements gaps and ambiguities to ensure alignment between business objectives and technical solutions.

Skills:

• Strong healthcare business and systems analysis expertise, including Medicaid and claims administration.
• Knowledge of HIPAA regulations, EDI X12 transactions, healthcare claims, provider enrollment, and eligibility processes.
• Proficiency in requirements documentation, business process modeling, and effort estimation.
• Experience with IBM Engineering Lifecycle Management (ELM) and ServiceNow.
• Ability to analyze mainframe data structures, interpret regulatory and policy changes, and communicate requirements to technical teams.
• Strong analytical, problem-solving, documentation, and stakeholder communication skills.

Experience:

• Experience as a Healthcare Business Analyst or Systems Analyst supporting Medicaid, healthcare claims, or government healthcare programs.
• Hands-on experience with CA-MMIS, including OIL analysis, mainframe tables/files, and policy updates.
• Experience with HIPAA EDI X12 transactions (837 I/P, 835, 270, 271, 276, and 277).
• Knowledge of CPT, ICD, and HCPCS code maintenance.
• Proven ability to facilitate stakeholder requirements sessions and translate complex business and regulatory needs into actionable system requirements.

Education:

• Bachelor's degree in Information Systems, Computer Science, Healthcare Administration, Business Administration, or a related field preferred.
• Equivalent relevant professional experience may be considered.

Excellent verbal and written English communication skills and the ability to interact professionally with a diverse group are required.

The expected base salary for this position ranges from $40.00 to $50.00/hour. Salary offers are based on a wide range of factors including relevant skills, training, experience, education, market factors, and where applicable, licensure or certifications obtained. In addition to salary, a competitive benefit package is also offered.

About CTG

CTG, a Cegeka company, delivers IT and business solutions that enhance clients' digital agility, empowering them to seize new opportunities and overcome any challenge. Backed by more than 60 years' experience and a commitment to being a reliable, results-driven partner, we work shoulder to shoulder with clients to shape digital together. Our vision is to be an indispensable partner to our clients and the preferred career destination for digital and technology experts. With more than 9,000 team members in over 15 countries, we combine global expertise with local insight to deliver innovative solutions. We operate across the Americas, Europe, and India, working with over 3,000 clients in many of today's highest-growth industries.

Together, we shape whats next- working shoulder to shoulder to deliver impactful solutions for our clients and society. Our culture is built by the people who work at CTG, the values we hold, and the actions we take. It's a living, breathing thing that is renewed every day through the ways we engage with each other, our clients, and our communities. At CTG, you'll find a workplace where you are encouraged to grow, supported in your ambitions, and empowered to shape your own career journey. For more information, visit www.ctg.com.

CTG will consider for employment all qualified applicants including those with criminal histories in a manner consistent with the requirements of all applicable local, state, and federal laws.

CTG is an Equal Opportunity Employer. CTG will assure equal opportunity and consideration to all applicants and employees in recruitment, selection, placement, training, benefits, compensation, promotion, transfer, and release of individuals without regard to race, creed, religion, color, national origin, sex, sexual orientation, gender identity and gender expression, age, disability, marital or veteran status, citizenship status, or any other discriminatory factors as required by law. CTG is fully committed to promoting employment opportunities for members of protected classes.