Location: Quincy, Massachusetts (MA)
Duration: 6 Months
Work Arrangement: Hybrid
Working Hours: Monday–Friday, 9:00 AM–5:00 PM
We are seeking an experienced Business Analyst to support a Medicaid Management Information System (MMIS), with a focus on provider reimbursement and claims processing. The ideal candidate will have a strong understanding of healthcare operations, health plan management, claims and payment processing, and the systems development life cycle (SDLC).
The Business Analyst will support the analysis, development, testing, and implementation of system enhancements to meet business requirements and regulatory standards. This role requires close collaboration with business stakeholders, developers, quality assurance teams, vendors, and other project personnel to ensure that system functionality aligns with business objectives and applicable federal and state regulations.
Candidates with experience in Medicaid systems, healthcare claims processing, and reimbursement operations are highly preferred.
Lead and participate in Joint Application Design (JAD) sessions with business stakeholders.
Gather, analyze, document, and validate business and functional requirements.
Support gap analysis, solution design, development, testing, implementation, and post-release stabilization.
Develop test strategies, test scenarios, and test cases based on documented requirements.
Execute and review test cases, validate results, and provide testing sign-off as appropriate.
Ensure system enhancements meet business requirements and applicable healthcare regulations.
Support the development of end-user training materials, functional documentation, and operational procedures.
Coordinate with vendors to ensure requirements are clearly defined, implemented, and tested.
Communicate project updates, system changes, and implementation impacts to relevant stakeholders.
Participate in business meetings and provide functional support for MMIS-related questions and issues.
Monitor system implementations, identify defects, and support resolution strategies during stabilization.
Perform data queries, data validation, and analysis to identify issues and recommend solutions.
Collaborate with project managers, developers, QA analysts, systems analysts, and business users.
Provide backup support to other Business Analysts when required.
Experience in business analysis across multiple phases of the systems development life cycle.
Knowledge of healthcare operations, claims processing, provider reimbursement, and payment transactions.
Understanding of business requirements gathering, functional documentation, and system testing.
Strong analytical and problem-solving skills, with the ability to evaluate complex business processes.
Proficiency in SQL and data analysis.
Excellent written and verbal communication skills.
Ability to work independently and collaboratively in cross-functional project teams.
Strong stakeholder management and documentation skills.
Experience with Medicaid Management Information Systems (MMIS).
Knowledge of Medicaid program operations and healthcare claims processing.
Familiarity with HIPAA-compliant claims and payment transaction processing.
Experience supporting provider reimbursement and claims-related system enhancements.
Knowledge of SDLC and Agile methodologies.
Experience coordinating with external vendors and healthcare program stakeholders.
Ability to analyze business and system issues and recommend practical solutions.
Bachelor's degree or higher in Business, Information Technology, Healthcare Administration, or a related field, with at least 3 years of relevant experience.
Equivalent experience in a healthcare administration environment may be considered.