Medicaid Systems Analyst

V Group Inc.; Columbia (SC); Hybrid; USD 90,000 - 120,000; Full time

Job summary

V Group Inc. is seeking a Systems Analyst - Consultant to support the legacy MMIS system for the Bureau of Medicaid Systems, focusing on reporting, analytics, testing, and operational support.

The role requires Medicaid healthcare experience, COBOL, and mainframe skills, plus EDI familiarity. Initial onsite work for 30-90 days, then a hybrid schedule. SC residents or relocations are required prior to start.

Qualifications

• 5 years Medicaid or healthcare experience.
• Proficient in COBOL programming language.
• 5 years experience operating healthcare Mainframe systems for payers as a technical analyst or related duties.
• At least 3 years experience with EDI transactions, including managing companion guides.
• Experience working with a Medicaid eligibility and/or enrollment information system in an operations capacity.
• Understanding of MMIS mainframe capabilities and intricacies.
• MVS COBOL, JCL, IDMS/NETWORK, CA-ADS, CHANGEMAN, SAS.
• 7+ years of equivalent experience in systems analysis and/or computer systems development/modification may be substituted.
• Bachelor’s degree in a technical, business, or healthcare field.

Responsibilities

• Serves as a liaison between the business programs and the IT organization to provide technical solutions to meet user needs.
• Develops, retrieves, and distributes reports and datasets to multiple internal and external stakeholders for purposes of monitoring, reconciliation, and operational processing.
• Performs operational support activities for the legacy MMIS and subsystems. Receives and responds to requests and inquiries from business stakeholders. Monitors vendor requests and coordinates between business and technical staff. Identifies trending issues and escalates to program management as needed. Translates business requests and needs into system requirements and technical requests. Serves as a subject matter expert associated with content, processes, and procedures.
• Performs highly complex analysis, design, and testing as an analyst, to meet the needs of the users of MMIS and its subsystems.
• Reviews and verifies QA and UA results as assigned. Documents issues and defects for triage and resolution.
• Proactively identifying risks, issues, and action items leading to possible solutions.
• Interacting with internal and external organizations (i.e. vendors, State and Federal government agencies, State providers, and other stakeholders).
• Works collaboratively with the MMIS vendor teams to support SDLC processes as well as support SCDHHS-specific code library changes to COBOL and JCL programs.
• Follows standard SDLC processes and contributes to ongoing process improvement.
• Communicates effectively in both written and spoken forms.

Skills

Medicaid/healthcare experience

COBOL programming language

Mainframe systems operations

EDI transactions

MMIS knowledge

Education

Bachelor’s degree in technical, business, or healthcare

Tools

MVS COBOL

JCL

IDMS/NETWORK

CA-ADS

CHANGEMAN

SAS

Job description

Note: Work Location: Fully onsite for the first 30-90 days with potential to switch to hybrid (3 days in office, 2 days remote).

Candidate Location: Candidate MUST be a SC resident or willing to relocate to SC prior to starting the role at their own expense.

Scope of The Project:

Seeking a Systems Analyst - Consultant to assist with supporting operations for the legacy MMIS system in the Bureau of Medicaid Systems. Related systems include the MMIS Online application, Provider Web Tool, Provider Enrolment application, and EDI/Translator. The principal duties of this position are to serve as a systems analyst for the MMIS team under general supervision by the Bureau Chief of Business Systems Management. As such, the systems analyst is responsible for activities supporting MMIS operational activities including reporting and analytics, systems support, testing.

Responsibilities:

• Serves as a liaison between the business programs and the IT organization to provide technical solutions to meet user needs.
• Develops, retrieves, and distributes reports and datasets to multiple internal and external stakeholders for purposes of monitoring, reconciliation, and operational processing.
• Performs operational support activities for the legacy MMIS and subsystems. Receives and responds to requests and inquiries from business stakeholders. Monitors vendor requests and coordinates between business and technical staff. Identifies trending issues and escalates to program management as needed. Translates business requests and needs into system requirements and technical requests. Serves as a subject matter expert associated with content, processes, and procedures.
• Performs highly complex analysis, design, and testing as an analyst, to meet the needs of the users of MMIS and its subsystems.
• Reviews and verifies QA and UA results as assigned. Documents issues and defects for triage and resolution.
• Proactively identifying risks, issues, and action items leading to possible solutions.
• Interacting with internal and external organizations (i.e. vendors, State and Federal government agencies, State providers, and other stakeholders).
• Works collaboratively with the MMIS vendor teams to support SDLC processes as well as support SCDHHS-specific code library changes to COBOL and JCL programs.
• Follows standard SDLC processes and contributes to ongoing process improvement.
• Communicates effectively in both written and spoken forms.

Required Skills and Education:

• 5 years Medicaid or healthcare experience. (Experience working with Medicaid claims and provider operations concepts)
• Proficient in COBOL programming language.
• 5 years experience operating healthcare Mainframe systems for payers as a technical analyst or related duties.
• At least 3 years experience with EDI transactions, including managing companion guides.
• Experience working with a Medicaid eligibility and/or enrollment information system in an operations capacity.
• Understanding of MMIS mainframe capabilities and intricacies.
• MVS COBOL, JCL, IDMS/NETWORK, CA-ADS, CHANGEMAN, SAS.
• 7+ years of equivalent experience in systems analysis and/or computer systems development/modification may be substituted.
• Bachelor’s degree in a technical, business, or healthcare field.

Preferred Skills:

• Subject Matter Expertise as it relates to MMIS Operations.
• Proficient in data analysis tools and techniques, such as SAS, Excel, data visualization tools, and statistical analysis software.
• Experience providing status reports and other technical or operational reports in a clear and concise manner.