IN4854-1
Business Analyst with process modeling, healthcare, insurance, EHR/EMR, medicaid, medicare, MITA, MECT, MMIS, SNAP/TANF and six sigma experience
Location: Columbia SC
Duration: 12 Months
Positions: 1
REQUIRED SKILLS (RANK IN ORDER OF IMPORTANCE):
- Deep experience with the design and implementation of business process modeling across an enterprise
- Ability to conceptualize, design, and document complex, interrelated processes
- Proven experience driving a culture of measurement-driven management and process innovation
- Superb written and oral communication skills, including the ability to train staff as well as give presentations to executive management. Strong proficiency in English is required.
- Experience and understanding of enterprise-class technology system infrastructure
- Experience in developing and testing business continuity plans for large enterprise environments
- Impeccable integrity. This project will have very high visibility and will impact significant expenditures of public funds. Candidates must be confident with their abilities to make correct decisions and the courage to speak out when necessary.
- Willingness and ability to effectively engage with people and organizations on a continuous basis to drive innovation and major cultural, process and technology transformation.
PREFERRED SKILLS (RANK IN ORDER OF IMPORTANCE):
- Experience in healthcare operations (IT and/or business) including claims payment, insurance systems, enterprise-class EHR/EMR (hospital systems)
- Experience in operations (IT and/or business) for government payer programs (Medicaid or Medicare)
- Understanding of the Medicaid Information Technology Architecture (MITA)
- Medicaid eligibility system and/or business operations experience
- Understanding of the Medicaid Enterprise Certification Toolkit (MECT)
- Experience with operations (IT and/or business) for SNAP or TANF programs
- Experience as part of a multi-organizational project team
REQUIRED EDUCATION:
Bachelor Degree or equivalent experience; Master’s Degree preferred.
REQUIRED CERTIFICATIONS:
Preferred – Training and/or certification in Six Sigma (Green Belt, Black Belt, or Master Black Belt), Lean, and/or other process improvement methodologies
Duties include:
- Supporting project teams in defining, documenting, and modeling existing and process models;
- Supporting project teams in designing and documenting future process models;
- Aligning process models with enterprise technology services;
- Conceptualizing and designing the flow of information throughout the enterprise in a way that aligns with the broader Department goals and strategy;
- Driving a culture of process innovation, high reliability and measurement-driven management throughout the organization;
- Defining and supporting Department-wide training and education guidance regarding business process modeling, process design, and measurement-driven management;
- Working closely with technology teams (application development and infrastructure) to design needed technologies to meet expected business performance;
- Working closely with business owners (program managers, contract administrators and project management team) to define requirements and translate those requirements into business process models and enterprise design;
- Seeking out opportunities for and ensuring business process “re-use” throughout the enterprise and consolidation of like operational functions;
- Supporting the design and implementation of business continuity planning;
- Other duties as assigned.
In addition to technical expertise, highly qualified candidates will also have experience and subject matter knowledge of Medicaid and/or health eligibility and delivery systems.
Familiarity with ICD-9/ICD-10 coding standards, X12 EDI transactions, and the Affordable Care Act and it impacts on Medicaid eligibility and health insurance exchanges is also beneficial.
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