Business Analyst III - Member Reconciliation

  • Rhode Island
  • Integrated Resources
This is a Scrum Team role that will be a member of the Medicare / Medicaid / Exchange Enrollment Configuration team tasked with developing purpose built capabilities for our NextGen platform. This role is responsible for delivering analysis, requirements of oversight for various Membership Integration and Reconciliation Stories within an Agile framework. • Performs analysis and translates business needs to create high-quality Business Requirements and Functional Specifications documentation within specified time frames to solve moderately complex problems (multiple interfaces with other systems within a business unit) considering all impacted components from an end-to-end perspective. • Performs data analytics using SQL / PLSQL at an intermediate level • Ensures end-to-end traceability of requirements is complete. • Applies specific functional and/or business expertise to perform assigned tasks and develop specific project deliverables. • Conducts impact analysis of configuration changes on business processes and existing technology. • Competent to work with minimal supervision in a technical capacity on most phases of the business systems analysis. • Contributes to the review of Test Planning and Test Execution strategies. • Develops business workflow diagrams. • Assists in the development of data models and interface design specifications. • Documents, tracks, and resolves issues related to data quality. • Contributes to the design and mapping of data conversion strategies. • Participates in collaborative system and data design sessions with the user community, technical architecture resources, and development resources. • Completes project activities on time and within budget, and proactively identifies and communicates issues that may jeopardize milestones or project budget to the Project Manager / Product Owner. • Adheres to SDLC or AGILE project management methodology by utilizing internal procedures and tools and identifying areas for methodology improvement. • Develops Product Overviews, FAQs, Tool Glossaries, system training material, and system user documentation to support implementation activities. • Creates appropriate communication materials are documented and distributed appropriately. • Conducts interviews, fact-finding, and independent research to design creative, progressive solutions for business problems. • Supports the Product Owner with other Scrum Team tasks (hosts / facilitates meetings, taking detailed notes, completes analysis / research) as needed

Position Summary:

This is a fantastic opportunity for a senior level developer / configuration / business analyst with more than six years of experience to transition into a position on the Medicare Next Generation Platform Team. We currently have an opening within our Medicare / Medicaid Next Generation Program team for a dynamic, self-starting, experienced analyst. The role will create new learning opportunities from both a technology perspective and a business process perspective in relation to Medicare and Medicaid Enrollment Operations.

Duties:

This is a Scrum Team role that will be a member of the Medicare / Medicaid Enrollment Configuration team tasked with developing purpose built capabilities for our NextGen platform. This role is responsible for delivering configuration for various enrollment, billing, reconciliation, correspondence and reporting Stories within an Agile framework. • Serves as a member of the team to deliver purpose built configuration for the Medicare Enrollment Operations Team on the Next Generation Platform. • Independently designs and / or configures efficient, cost effective application program solutions for the Enrollment Operations Team on the Next Generation Platform Program for the Medicare organization, including products for Medicare Advantage (MA), Medicare Advantage with Prescription Drug Coverage (MAPD) and stand-alone Prescription Drug Plans (PDP) and potentially Medicaid. • Able to write SQL / PLSQL at an intermediate to advanced level • Able to develop in DataStage • Develops new and / or reuses existing configuration through the use of program development software and / or integrates purchased solutions. • With limited direction, translates business requirements to technical specifications. • Creates technical designs for a new application or enhancements, including integration of purchased solutions. • Performs ongoing system maintenance, research, problem resolution and on-call support, according to defined plans or documentation for existing systems. • Is fully familiar with the prescribed methodology and is in strict compliance with all required artifacts. • Independently performs unit testing. May perform or assist with integration and system testing, according to detailed test plans to ensure high-quality systems. • May assist business partners with User Acceptance Testing. • Independently supports processes related to the implementation of systems into production, including integration of purchased solutions. Independently works on multiple projects and/or SRs and actively participates as a member of each project team supporting an application or set of applications. • Independently works on small and large moderately complex projects that require increased skill in multiple technical environments and disciplines, that have system wide impact and that may integrate across the organization. • Supports reviews and signs off on all design documents prior to configuration. • Supports reviews of all configuration built by other Business Consultants. • Supports Leads with coaching / mentoring for other Business Consultants performing configuration within the system.

Primary candidates will have worked with MHK's software called Market Prominence in an analytical capacity (i.e. must be an advanced user of PLSQL). Secondary candidates will have Medicare and / or Medicaid Enrollment experience in an analytical role or IT role within the software configuration / development space. Tertiary candidates will have analytical experience within either a business or IT related role. Prior experience with the implementation of a Medicare / Medicaid Enrollment application would be a strong plus! Keywords: Market Prominence, Medicare Enrollment, Medicare Billing, Medicaid Enrollment, Medicaid Billing, Software Development, Software Configuration.

Experience:

Required • Experience MS SQL databases; Intermediate / Advanced (2-4 years) • Experience IBM DataStage; Intermediate / Advanced (2-4 years) • Experience with software development lifecycles; application development (2-4 years)

Preferred • Experience with Market Prominence, MHK's (formerly MedHOK) Enrollment, Billing and Correspondence platform • Information Technology / Release & Resource Management (2-4 years) • Medical Management / Medical Management - Government Administration (2-4 years) • Experience with member materials / correspondence implementation experience (2-4 years) • Experience with Medicare or Medicaid Enrollment, Billing and Correspondence Operations (2-4 years) • Leadership / Creating Accountability (Intermediate) • Leadership / Developing and Executing Strategy (Intermediate) • Leadership / Driving a Culture of Compliance (Foundational) • General Business Consulting for Solutions (Intermediate) • Leadership / Anticipating and Innovating (Intermediate) • Technology / Justifying the Business Case (Intermediate) • Experience with enterprise-wide and / or cross-functional large scale initiatives with high degree of complexity. • Demonstrated experience successfully implementing change in complex organizations • Demonstrated relationship management skills at the senior level; capacity to quickly build and maintain credible relationships at varying levels of the organization simultaneously.

Education:

Bachelor's degree in Computer Science or a related discipline.