We are seeking a Senior Business Analyst with deep expertise in Medicaid/MMIS systems to act as a subject matter expert across claims, eligibility, enrollment, and provider modules. The ideal candidate will have strong business analysis skills, experience in Medicaid systems, and the ability to translate complex business needs into actionable requirements.
Serve as a Medicaid/MMIS Subject Matter Expert across claims, eligibility, enrollment, and provider modules
Lead requirements gathering, business process analysis, and documentation including:
Business Requirement Documents (BRDs)
Functional Requirement Documents (FRDs)
User stories
Translate complex business needs into clear functional and technical requirements
Collaborate with stakeholders, product owners, and development teams to ensure alignment
Ensure compliance with CMS guidelines, HIPAA , and state Medicaid regulations
Support defect management and production support activities
Identify process improvement opportunities and support system modernization initiatives
Mentor junior business analysts and contribute to Agile delivery processes
7-12 years of experience in the Medicaid domain , with strong MMIS experience
Deep understanding of:
Claims processing
Eligibility systems
Provider management systems
Proven experience in business analysis, stakeholder engagement, and documentation
Hands-on experience with Agile/Scrum methodologies
Strong analytical, communication, and problem-solving skills
Experience with MMIS platforms such as Facets, QNXT, MES, etc.
Knowledge of HL7/FHIR and healthcare data exchange standards
Experience working with state Medicaid agencies or healthcare payers
Medicaid/MMIS domain expertise
Business process analysis and documentation
Agile delivery and collaboration
Stakeholder management and communication
Problem-solving and process improvement
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