PM/BA - Claims
Apply NowCompany: United Software Group, Inc.
Location: Quincy, MA 02169
Description:
Position: PM/BA - Claims
Location: Quincy, MA 02171
Contract
Job Description:
Must Haves:
-Senior level resource
-Previous Claims and Provider experience
-Medicaid experience
-Healthcare background
-Worked in Hospital setting and understands processes and regulations
-The PM aspect of this role will be someone who can come up with the Scope of the work when they aren't given a ton of information, get the business case and "know what do we need to support them"
-Person can work with executives and handle themselves professionally
DETAILED LIST OF JOB DUTIES AND RESPONSIBILITIES:
Qualifications:
Education and Certifications:
Location: Quincy, MA 02171
Contract
Job Description:
Must Haves:
-Senior level resource
-Previous Claims and Provider experience
-Medicaid experience
-Healthcare background
-Worked in Hospital setting and understands processes and regulations
-The PM aspect of this role will be someone who can come up with the Scope of the work when they aren't given a ton of information, get the business case and "know what do we need to support them"
-Person can work with executives and handle themselves professionally
DETAILED LIST OF JOB DUTIES AND RESPONSIBILITIES:
- Lead and participate in joint application design session with stakeholders
- Knowledge of SDLC and Agile methodology a plus
- Develop test strategies, test scenarios and test cases based on written requirements
- Execute and review test runs and sign off on testing components
- Document requirements and participate in their development and testing
- Ensure alignment and use of MMIS SDLC or Agile methodology and operating practices.
- Ensure all project initiatives have a project plan and traceability, risk/issues list, and project MS SharePoint documentation site.
- Ensure coordination of resource support across MMIS Business Analysis, SQA, and Development teams; as well as peer managers to align with capacity planning practices.
- Prepare and distribute weekly project status reports on progress against planned, risks, and mitigation strategies.
- Support the development of end-user training materials and end-user documentation as required.
- Possible oversight role during the stabilization phase of each release including the monitoring of system change execution, the development of system "fix" strategies and the close monitoring of the implementation of those strategies
- Work with vendors to ensure business requirements are fully defined and tested.
- Communicate updates and changes to impacted stakeholders
- Represent MMIS in business meetings as needed
- Support program staff, vendors, and other stakeholder with MMIS related questions or concerns.
- Provide back up to other business analysts as needed.
- Data query and analysis.
Qualifications:
- Proficient in business analysis to support all stages of system project lifecycle
- Competency in HIPAA claims and payment transaction processing
- Strong data analysis skills- SQL proficient
- Excellent communication and documentation skill
- Excellent interpersonal skills necessary to interact effectively with project managers, developers, business analysts, systems analysts, SQA analysts, business users/stakeholders, and data processing personnel; as well as interact with representatives from external agencies and companies.
- Demonstrated ability to work independently, as well as within project teams, providing relevant system analysis services.
- Highly analytical, with the ability to independently analyze, document findings and recommend solutions.
Education and Certifications:
- Bachelor's degree or higher in Business, IT or Healthcare administration with
- minimum 3 years' experience in large healthcare setting.