Medicaid SME

Medicaid Specialist /SME Columbia South Carolina 29201 Interview Process: 1 round, Virtual/Online Remote SCOPE OF THE PROJECT: seeking a Systems Analyst-Consultant to assist with supporting operations for the legacy MMIS systems. Related systems include the MMIS Online application, Provider Web Tool, Provider Enrollment application, and EDI/Translator Objectives to Be Fulfilled by Candidate: The principal duties of this position are to serve as a systems analyst for the MMIS team. As such, the systems analyst is responsible for activities supporting MMIS operational activities including reporting and analytics, systems support, testing. Specific duties include, but are not limited to: • Serves as a liaison between the business programs and the IT organization to provide technical solutions to meet user needs. • Develops, retrieves, and distributes reports and datasets to multiple internal and external stakeholders for purposes of monitoring, reconciliation, and operational processing. • Performs operational support activities for the legacy MMIS and subsystems. • Receives and responds to requests and inquiries from business stakeholders. • Monitors vendor requests and coordinates between business and technical staff. Identifies trending issues and escalates to program management as needed. • Translates business requests and needs into system requirements and technical requests. Serves as a subject matter expert associated with content, processes, and procedures. • Performs highly complex analysis, design, and testing as an analyst, to meet the needs of the users of MMIS and its subsystems. • Reviews and verifies QA and UA results as assigned. Documents issues and defects for triage and resolution. • Proactively identifying risks, issues, and action items leading to possible solutions. • Interacting with internal and external organizations (i.e. vendors, State and Federal government agencies, State providers, and other stakeholders). REQUIRED SKILLS : • 3 years Medicaid or healthcare experience. (Experience working with Medicaid claims and provider operations concepts.) • Proficient in COBOL programming language. • 3 years experience operating healthcare Mainframe systems for payers as a technical analyst or related duties. • At least 3 years experience with EDI transactions, including managing companion guides. • Experience working with a Medicaid eligibility and/or enrollment information system in an operations capacity. • Understanding of MMIS capabilities and intricacies. PREFERRED SKILLS : • Subject Matter Expertise as it relates to MMIS Operations. • Proficient in data analysis tools and techniques, such as SAS, Excel, data visualization tools, and statistical analysis software. • Experience providing status reports and other technical or operational reports in a clear and concise manner Education: Bachelor’s degree in a technical, business, or healthcare field. 3+ years of equivalent experience in systems analysis and/or computer systems development/modification may be substituted.