Remote Healthcare BA & Systems Analyst

Computer Task Group; 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 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.