Senior Business Analyst – Medicaid/MMIS SME (D04)
Key Responsibilities
- Act as a Medicaid/MMIS SME across claims, eligibility, enrollment, and provider modules
- Lead requirements gathering, business process analysis, and documentation (BRDs, FRDs, user stories)
- Translate complex business needs into clear functional and technical requirements
- Collaborate with stakeholders, product owners, and development teams
- Ensure compliance with CMS guidelines, HIPAA, and state Medicaid regulations
- Support defect management, and production support
- Identify process improvements and support system modernization initiatives
- Mentor business analysts and contribute to Agile delivery
Requirements
- 7–12 years of experience in Medicaid domain, with strong MMIS experience
- Deep understanding of claims processing, eligibility, and provider management systems
- Proven experience in business analysis, stakeholder engagement, and documentation
- Hands‑on experience with Agile/Scrum methodologies
- Strong analytical, communication, and problem‑solving skills
Preferred Qualifications
- Experience with MMIS platforms (Facets, QNXT, MES, etc.)
- Knowledge of HL7/FHIR and healthcare data exchange standards
- Experience working with state Medicaid agencies or healthcare payers