IN4697-1
Business Analyst (SME) with ICD-10/9, medicaid/healthcare, HIPAA 5010, MS Office, project management (PMP) and QA testing experience
Location: Columbia, SC
Qty: 1
Duration: 12 Months
COMPANY / DEPARTMENT CULTURE
SECONDARY WORK LOCATION: Some day and/or overnight travel to Clemson University, Clemson/Seneca/Anderson/ Greenville, SC
The team is comprised of healthcare professionals with both business and technical experience. Successful candidates must be individuals who are highly productive, very flexible, willing collaborators, need minimal supervision, and are self-motivated. Candidates who enjoy working on complex, change-oriented project with motivated team members, will find this position attractive. This role is only for ICD-10 implementation.
ICD-10 represents a major improvement to medical coding practices (diagnosis and procedure codes) that impact both providers and payers requiring significant changes to related health care policies, business processes and information systems. ICD-10-CM will completely replace ICD-9-CM for dates of service on or after October 1, 2014; and ICD-10-PCS will replace ICD-9-CM for dates of discharge on or after October 1, 2014.
Criminal record check.
EXPERIENCE REQUIRED: ICD-10 and Medicaid experience is desirable.
DAILY DUTIES / RESPONSIBILITIES:
Under the guidance of the Project Manager, the Business Analyst will provide business and technical consulting services to for ICD-10 remediation and other concurrent business requirements as a result of the ICD-10 implementation, mandated by the Centers of Medicare and Medicaid Services (CMS), with Clemson University (CU), the Department of Health and Human Services (DHHS) of the State of South Carolina, and impacted agency functional areas and external partners as related to assessment, remediation and implementation of the ICD-10 initiative. Serve as a subject matter expert (SME) working with senior level management to identify impacts, analyze issues and drive solutions for the ICD-10 initiative. Perform business impact assessment, write detail reports and specifications, drive needs into design and support activities such as testing for follow-on application development and system integration.
Role requires a strong ICD-9/ICD-10 business analyst with healthcare (preferably Medicaid) experience. Using ICD-9 code set experience, conduct business impact assessment, perform gap analysis, and document impacted medical policies and business processes. To support the ICD-10 engagements the candidate must have extensive knowledge of healthcare business processes in order to perform evaluations of ICD-10 points of contact. Using past experience you must develop assessment reports, alternative solutions, recommendations and the creation of an implementation roadmap.
In the remediation phases the candidate will be responsible for documenting functional design documentation, perform project management activities, support development of test scenarios/cases and the execution of testing activities.
REQUIRED SKILLS (RANK IN ORDER OF IMPORTANCE):
THE ABILITY TO:
- Perform impact assessment, write detail reports and specifications, drive needs into design and support activities such as testing for followon application development and system integration.
- Documenting functional design documentation, perform project management activities, support development of test scenarios/cases and the execution of testing activities.
- Working knowledge of ICD-9 and ICD-10 initiatives.
- Excellent leadership, organizational, and communication skills (verbal and writing).
- Proven consulting experience with ability to work at both the senior manager level and staff level.
PREFERRED SKILLS (RANK IN ORDER OF IMPORTANCE):
- At least 5 years of experience working in a healthcare environment (preferably Medicaid)
- Five plus years of Business Analysis experience gathering/documenting business requirements and translating into technical specifications.
- Deep knowledge of healthcare operations (preferably Medicaid), business processes.
- Working knowledge of ICD-9 coding and medical policy interpretation.
- Previous leadership assignments and project management experience.
- Previous experience in conducting impact assessment is a plus.
- Previous experience in HIPAA 5010 transaction set a plus.
- Proficient in the Microsoft Tool Suite
REQUIRED EDUCATION:
Bachelor’s degree in a technical, business, or related field. Years of experience can substitute for formal education.
REQUIRED CERTIFICATIONS:
None required. Technical and/or Project Management certifications from recognized sources are desirable.
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