Medicaid MMIS Business Analyst – Claims & Data Expert

Tier4 Group; Quincy (MA); Hybrid; USD 90,000 - 115,000; Full time

Job summary

Tier4 Group seeks an experienced Business Analyst to support a healthcare technology team responsible for Medicaid MMIS-based claims processing and provider reimbursement. The role covers requirements gathering, analysis, testing, implementation, and post-production support in a large-scale Medicaid environment.

The ideal candidate has healthcare domain knowledge, strong analytical and communication skills, and the ability to collaborate with business stakeholders, technical teams, and external

Qualifications

• Bachelor's degree or equivalent experience in a related field.
• 3+ years of BA experience supporting healthcare systems.
• Experience with Medicaid, MMIS, healthcare claims processing, or provider reimbursement systems.
• Strong requirements gathering, analysis, and documentation skills.
• Experience across SDLC.
• Strong SQL and data analysis skills.
• Knowledge of HIPAA claims and payment processing.
• Excellent communication and stakeholder management.
• Ability to work independently and in cross-functional teams.

Responsibilities

• Facilitate requirements sessions and define business needs with stakeholders.
• Document business, functional, and system requirements; perform gap analysis.
• Participate in design, development, testing, implementation, and stabilization activities.
• Develop test strategies, scenarios, cases; support SIT, UAT, and regression testing.
• Review test results, document defects, and support resolutions.
• Create and maintain business process docs, workflows, and user guides.
• Collaborate with vendors and technical teams to ensure correct implementation.
• Communicate project updates, risks, and changes to stakeholders.
• Support production deployments and stabilization activities.

Skills

Medicaid MMIS

SQL and Data Analysis

Requirements Gathering

SDLC

HIPAA Claims and Payments

Education

Bachelor's degree in Business / IT / Healthcare Admin

Tools

Test Management Tools

Job description

Tier4 Group seeks an experienced Business Analyst to support a healthcare technology team responsible for Medicaid MMIS-based claims processing and provider reimbursement. The role covers requirements gathering, analysis, testing, implementation, and post-production support in a large-scale Medicaid environment.

The ideal candidate has healthcare domain knowledge, strong analytical and communication skills, and the ability to collaborate with business stakeholders, technical teams, and external