Senior Business Systems Analyst
4 weeks ago
About this role
We are seeking a skilled Business Systems Analyst to join our team at Gainwell Technologies. As a Business Systems Analyst, you will play a critical part in ensuring that our clients' objectives are met in important areas.
Your key responsibilities
- Coordinate the duties and activities of a business analyst team on IT projects and provide guidance and support to newer team members.
- Act as a knowledgeable bridge between clients, project managers, and technical staff to define, document, and share business requirements and expected impact.
- Work with clients to develop business specifications at the start of a technical project.
- Analyze, plan, design, document, or make recommendations to improve business processes to support clients' technology goals.
- Verify that all requirements have been met by approving and validating test results.
- Use basic analytical or relational database software such as Excel or SQL to quantify the anticipated impact of work.
What we're looking for
Qualifications
- Bachelor's degree or equivalent combination of education and experience.
- Six or more years of business analysis experience.
- Openly and actively communicates information and takes initiative to communicate extensively.
- Four or more years of experience configuring in QNXT or FACETS.
- Contracts/benefits.
- System data points needed for successful X12 transactions, Claim Adjustment Reason Codes, and Remittance Advice Code.
- Contracts for provider services, benefits for member coverage, fee schedules, capitation, and claim editing enforcement.
- Understands Medicaid Program structure in carriers, programs, benefit plans, policy, policy plans, sponsor, and/or policies.
- Understands Provider (Contract and Pricing) data including but not limited to provider type, specialty, taxonomy, enrollment impacts, service locations, certifications, and licensing, affiliations, and reimbursement impacts.
- Understands Member data including but not limited to aid categories, coverage codes, benefit packages, restrictions, limitations, prior authorizations, programs, and primary care providers.
- Experience with Configuration Implementation Build & Maintenance.
- Experience working with complex systems at a detailed level.
- Experience working in a virtual team environment performing self-directed tasks.
- Understands relational database concepts and schemas.
- Experience writing SQL queries for data analysis.
- Experience working with Medicaid/MMIS systems.
- Preferred experience includes DDI (Design, Development, and Implementation) and operations phases.
- Experience processing Medicaid claims and ability to troubleshoot adjudication results.
- Demonstrated aptitude for learning new technologies and keeping current with industry best practices.
- Experience with Requirement Traceability Matrices.
- Ability to multi-task and maintain organization in a fast-paced environment.
- Ability to create and maintain highest levels of confidentiality when dealing with proprietary or private information.
- Ability to exercise sound judgment and make decisions in a manner consistent with the essential job function.
- Preferred experience working with HP Application Lifecycle Management (ALM).
About the role
This is a challenging and rewarding work environment that offers a balance between work and personal life. You will have the opportunity to work in a hybrid office environment and will be required to work late evenings to overlap US work hours.
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