Carrer

Healthcare Business Aanalyst - Direct Client
Immediate Interview and Start ASAP!!!

Please send resume to Sam@cncconsulting.com

Job Title: Healthcare Business Aanalyst
Location: Columbia, SC
Duration: 12 Months
Direct Client Position
            
The Business Analyst will work with various internal teams including Program Management/Project Managers, and other SMEs to evaluate Healthy Connections Prime business requirements. Provides technical designs to provide analysis and advice on strategies for information technology solutions and non-technical solutions. The majority of system development work will be outsourced to vendors and/or other state organizations.

We are looking for candidates who are highly organized, can work independently in a fast-paced environment and produce multiple quality deliverables with varying deadlines. Candidates should be self-starters and creative problem solvers and have the flexibility to learn new products and technologies quickly.

Subject matter areas include: Provider Management, Member (beneficiary) management/eligibility, Claims editing and pricing (professional, institutional, pharmacy, dental, durable medical equipment, transportation, etc.), Claims Payment and State budget assignment, Financial Management, Provider re-imbursement methodology, third party liability, drug rebate, prior authorization, managed care, behavioral health, long-term care, program integrity, electronic health records, benefit plan administration, etc.

Familiarity with X12 EDI transactions is also beneficial.

REQUIRED SKILLS/KNOWLEDGE:
Finance experience required on Project planning and financial budgeting
Training and experience in financial analysis and assessment;
Experience in the financial analysis of large health data systems;
Experience in government Medicaid financial reporting;
Experience in state Medicaid MARS/SURS financial analysis and reporting;
Strong background and at least six years experience in healthcare insurance business operations (payer or provider side; government or commercial side). Note: IT operations are not the same as business operations.
At least four years experience in healthcare insurance IT software/systems implementations performing duties described in the "Daily Duties/Responsibilities" section above.
Ability to properly document business requirements.
Ability to create/interpret business process and business data models.
Vendor management experience
Superb written and oral communications skills, including the ability to give presentations to executive management. Strong proficiency in English is required.
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.
Agile, waterfall, SDLC, PLC
Requirements gathering experience.

PREFERRED SKILLS:
Understanding of the Medicaid Information Technology Architecture (MITA).
Understanding of the Medicaid Enterprise Certification Toolkit (MECT).
Experience with traditional Medicare or Medicare Advantage
Experience in an outsourced healthcare insurance operations environment.
Experience on an outsourced IT development project.

PUBLIC SECTOR/GOV'T EXPERIENCE REQUIRED?
Not required, but preferred.              

Please send resume to Sam@cncconsulting.com
 
Thanks,
Sam
CNC Consulting, Inc.
201-546-3096
Sam@cncconsulting.com