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Business Analyst with Claims || Austin, TX , every Tuesday onsite || Need local || Prior State client exp at Austin, Texas, USA
Email: [email protected]
Title

:            
Business Analyst with Claims

Location            
:

Austin, TX , every Tuesday onsite , Need Local to TX

Duration

:             12
Month

Prior
State client exp Must .

All work products resulting from the project shall be considered "works
made for hire" and are the property of the Texas Health and Human Services
Commission  and may include pre-selection requirements
that potential Vendors (and their Candidates) submit to and satisfy criminal
background checks as authorized by Texas law. Texas Health and Human Services
Commission will pay no fees for interviews or discussions,
which occur during the process of selecting a Candidate(s).

The Claims Management Division (CMD) within the
Medicaid and CHIP Services Department is responsible for Long Term Care Claims
Adjudication through management of the Claims Management System and related
support operations.

Per House Bill 1, 88th Legislature,
2023, (Article II, HHSC, Rider 25), beginning on September 1, 2024, HHSC must
develop and implement a Texas version of the Nursing Facility (NF) Patient
Driven Payment Model (PDPM) methodology for the reimbursement of long-term stay
nursing facility services in the Medicaid program to achieve improved care for
long-term stay nursing facility services, excluding services provided by a
pediatric care facility or any state-owned facilities. 

The Worker will perform business analyst
and support work for the NF PDPM technology project for CMD. These changes
impact the Medicaid Management Information System (MMIS)/Medicaid Enterprise
Systems (MES) to support the new nursing facility payment methodology for
Long-Term Services and Supports. The Worker will be responsible for delivering
quality products that meet the state's desired operational and technical
requirements. The Worker will have considerable latitude to use their
experience and judgement to ensure successful completion of their assigned
tasks. The Worker will be required to multi-task, analyze priorities,
communicate clearly, and set expectations for the phases of the project. The
Worker will be responsible for communicating with multiple internal and external
stakeholders including program and technical staff, and other contracted and
vendor resources. The Worker will participate in meetings, track deliverables
and schedules, and alert management of any issues that may impact
providers. 

The services to be provided include, but
are not limited to the following:

A. Analyzes program policies,
procedures, and processes to determine the impact on business systems and
functional areas.

B. Analyzes and reviews system, data,
and project deliverables such as business user requirements, design
documentation, test plans, and risk assessment plans to ensure business and
technical requirements are met.

C. Works with Program area staff to
solicit, analyze and document business processes and requirements.

D. Acts as a liaison between state staff
and vendors to translate operational and business requirements to vendors.

E. Analyzes and writes User Stories with
Acceptance Criteria based on business needs and according to the Agile
methodology.

F. Develops and maintains business user
test scenarios and participates in systems and user acceptance testing.

G. Creates use case scenarios, test
plans, and exit criteria that accurately map back to the documented business
requirements or user stories.

H. Reviews, analyzes and executes test
cases with a formal testing tool.

I. Tracks, documents and reports the
status of testing.

J. Evaluates proposed test strategies to
ensure appropriate test coverage.

K. Identifies potential project risks
and issues and develops mitigation strategies.

L. Reports project status to management
on established timelines. 

M. Documents action items and business
decisions.

N. Performs meetings and/or presentation
tasks as needed.

O. Manages schedule for deliverables as
established.

P. Other duties as assigned in support
of the NF PDPM project.

II.  CANDIDATE SKILLS
AND QUALIFICATIONS

Minimum Requirements:

Candidates that do not meet or exceed the minimum stated
requirements (skills/experience) will be displayed to customers but may not be
chosen for this opportunity.

Years    Required/Preferred       Experience

5            Required            Experience in performing complex
business analysis and writing technical documentation.

5            Required            Experience reporting project status
to management including risks, issues, and key decisions.

5            Required            Experience identifying project risks
and issues; and developing/implementing mitigation strategies.

5            Required            Experience in effective general
written/oral communication, including documenting requirements, deliverables,
test scenarios and project status.

5            Required            Experience utilizing business
analysis skills and interacting with business end users to gather, validate and
document business requirements and translate into technical solutions to
satisfy the business needs to technical staff.

5            Required            Experience performing review and
approval processes of complex technical user and system requirements written by
vendors.

5            Required            Experience with Microsoft Office
products (e.g., Teams, Word, Excel, etc.).

5            Required            Experience coordinating and developing
test plans/strategies, exit criteria and test scenarios.

5            Required            Experience executing detailed test
cases within a complex software environment.

5            Required            Experience using testing management
software.

5            Required            Experience with Microsoft Project or
similar project management software.

5            Required            Experience utilizing the Agile
software development methodology.

5            Required            Experience as Business Analyst.

2            Preferred           Experience with Texas Medicaid system
and processes.

2            Preferred           Experience in claims processing.

2            Preferred           Experience as a Product Owner for an
agile team including working with agile/scrum teams of software contracted
vendors to implement system changes.

Regards

_______________________________

Suryangi

Resource Consultings Services Inc.

Parsippany, NJ 

Email: 
[email protected]

www.rconsultinginc.com

--

Keywords: information technology New Jersey Texas
Business Analyst with Claims || Austin, TX , every Tuesday onsite || Need local || Prior State client exp
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Tue Sep 03 23:45:00 UTC 2024

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Location: Austin, Texas