*WISCONSIN RESIDENTS ONLY* State Medicaid and MMIS Business Analyst 3

Sundial Software

*WISCONSIN RESIDENTS ONLY* State Medicaid and MMIS Business Analyst 3

Madison, WI
Full Time
Paid
  • Responsibilities

    The State of Wisconsin DHS is looking for a Business Analyst/Consultant III.

    *MUST BE CURRENT WISCONSIN RESIDENT*

    Top Skills & Years of Experience: 3 to 5 years of experience performing a business analyst role supporting State Medicaid and MMIS, or similar health care business

    o System Project Management and Oversight

    o Data Analysis and Policy Support

    o Coordination and Collaboration

    Nice to have skills:

    o Certified Business Analysis Professional (CABP) preferred

    o Excellent interpersonal communication skills

    o Excellent organization and time management skills

    Remote or on-site? This position is remote, but work must be performed within the State of Wisconsin - WI residency IS REQUIRED. No relocation allowed. Selected candidate will be required to be onsite in Madison, Wisconsin once a month.

    Additional Details: Industry skills and experience

    o 3 to 5 years of experience performing a business analyst role supporting State Medicaid and MMIS, or similar health care business and system in one or more of the following functional areas:

    \- Provider management

    \- Member (recipient) eligibility and enrollment

    \- Claims and encounters

    \- Benefit plan

    Under the general supervision of the Section Manager, Program Participation Oversight

    (PPO) in the Bureau of Quality & Oversight (BQO), this position is primarily responsible for

    the operational administration of the adult long-term care (LTC) provider enrollment system.

    1\. System Project Management & Oversight

    o Serve as the primary point of contact for assigned systems projects.

    o Provide operational administration over the adult long-term care (LTC)

    provider enrollment system.

    o Lead the end-to-end project lifecycle including the development of business

    requirements, review of design documentation, flowcharts, file and report

    layouts, coordinate User Acceptance Testing, and conduct Production

    Verification to ensure the system changes meets BQO and DMS needs.

    o Identify and document data inconsistencies or system bugs and work with

    vendors to resolve operational issues.

    o Provide direction and technical assistance to internal and external teams to

    update, manage, analyze the system.

    2\. Data Analysis & Policy Support

    o Utilize SAS and OnBase case and project tracking systems to execute regular

    and ad hoc queries from the EDW/DAR for data extraction in support of

    advancing adult provider enrollment, assess network adequacy, and conduct

    other policy research as assigned.

    o Analyze department policies, state and federal regulations, statutes,

    administrative codes and guidelines to inform necessary maintenance and

    enhancements to assigned systems areas.

    o Learn and understand data, interfaces, and extracts and make conclusions to

    be presented to leadership for decision making purposes.

    o Conduct review of trends and utilization patterns of adult LTC provider

    enrollment related data, interfaces, and extracts systems and make

    recommendations to management.

    o Update, input and maintain the adult LTC provider enrollment system

    integrity and user reliability.

    o If applicable, conduct research and provide ongoing information and

    consultation to BQO leadership and vendor(s) to maintain and improve adult

    LTC provider enrollment system operations.

    3\. Coordination & Collaboration

    o Independently resolve problems by working with appropriate staff or vendor

    staff to identify and resolve any conflicts in the adult LTC provider

    enrollment system and its operation(s).

    Knowledge Services RFS Summary

    2

    o Meet with BQO staff, contracted agencies, and long-term care providers to

    determine systems problems, prepare analysis of identified problems,

    develop systems specifications and tests to correct problems and monitor

    their implementation.

    o Present data in a usable format for BQO staff and leadership in the

    appropriate form of charts, graphs, reports and tables.

    o When requested, present data orally with appropriate presentation

    materials.

    o Independently work with appropriate staff or vendor staff to identify,

    research, and resolve data, interfaces, and extracts validity and integrity

    issues.

    Position Skills, Abilities, and Knowledge:

    • Proficient knowledge of the Medicaid MMIS including the systems operated by the

    fiscal agent (interChange and OnBase), the EDW/DAR (SAS), and the

    eligibility/enrollment system (CARES) including the basic operation of these systems

    and their capabilities.

    • Experience with the system development life cycle, with skills in the areas of

    business requirements development and ensuring consistent quality.

    • Extensive knowledge of Microsoft Excel, SAS Systems, Tableau, and/or other data

    analysis software.

    • Knowledge of research design methods, management reporting techniques, and

    statistics.

    • Advanced oral and written communication and presentation skills.

    • Knowledge of the State of Wisconsin adult long-term care programs.

    • Extensive knowledge of Medicaid and other health care program reporting and data.

    • Knowledge and ability to analyze large datasets and interpret results from statistical

    tools.

    • Extensive knowledge of Federal Health Insurance Portability and Accountability Act

    (HIPAA) regulations and transaction and data standards.

    • Ability to work independently and as part of a team.

    • Skill in conducting meetings and working effectively with people.

    • Skill in the use of problem-solving techniques involving complex situations and

    multiple viewpoints.

    • Demonstrated ability to collaborate with public and private agencies and service

    delivery systems.

    • Experience working in a complex, matrix work environment.