Senior Business Analyst – Medicaid Provider Enrollment Modernization
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Job Description
Senior Business Analyst modernizing Medicaid provider enrollment portals, workflows, and integrations. Supporting S2Tech’s health and human services IT consulting projects.
Responsibilities:
- Support a Medicaid provider enrollment modernization initiative
- Facilitate discovery sessions with Medicaid policy, provider enrollment, operations, technical, security, and vendor stakeholders
- Analyze current provider enrollment processes, workflows, business rules, system interfaces, forms, notices, and operational pain points
- Elicit, document, validate, and maintain business, functional, nonfunctional, data, and integration requirements
- Translate business needs into user stories, use cases, process flows, business rules, requirements traceability documentation, and acceptance criteria
- Define requirements for a provider-facing enrollment portal supporting application initiation, saving, submission, document upload, and status tracking
- Document portal workflows, page flows, data requirements, user roles, and navigation needs with UI/UX and development teams
- Support authentication, role-based access, accessibility, security, and enterprise identity-management integration requirements
- Analyze and document OnBase workflow enhancements for provider screening, licensing validation, risk assignment, notifications, site visits, fraud indicators, status changes, and work-queue automation
- Define data mappings, interface requirements, ingestion rules, validation rules, exception handling, and two-way data exchanges across OnBase, MMIS, portal, and integration teams
- Analyze provider enrollment data involving NPIs, taxonomy, licenses, affiliations, revalidation, ownership, group and individual relationships, and ordering/referring/prescribing providers
- Identify opportunities to reduce manual processing, improve data quality, increase workflow visibility, and automate enrollment activities
- Coordinate stakeholders to clarify requirements, resolve gaps, manage changes, and evaluate downstream impacts
- Review system designs and technical artifacts for alignment with approved requirements
- Support sprint planning, backlog refinement, demonstrations, defect review, and other Agile activities
- Develop test scenarios and expected results from approved requirements and business rules
- Support system integration testing, user acceptance testing, regression testing, defect triage, and functionality validation
- Maintain requirements traceability through design, development, testing, and implementation
- Prepare status updates, meeting notes, decision logs, risk and issue documentation, and other project artifacts
Requirements:
- At least seven years of experience as a Business Analyst supporting complex information technology or systems-modernization projects
- Experience eliciting, documenting, validating, and managing detailed business and functional requirements
- Experience developing process flows, user stories, use cases, business rules, data requirements, acceptance criteria, and requirements traceability matrices
- Experience working with business stakeholders, developers, architects, testers, operations teams, and third-party vendors
- Experience analyzing system interfaces, data exchanges, workflow automation, and cross-system dependencies
- Experience supporting system development, integration, testing, defect resolution, and implementation activities
- Strong facilitation, analytical, problem-solving, documentation, and written and verbal communication skills
- Ability to translate complex policy and operational needs into clear, actionable requirements for technical teams
- Ability to manage multiple workstreams, priorities, and stakeholders in a complex project environment
- Experience working in Agile or hybrid Agile delivery environments
- Bachelor’s degree in business, information systems, healthcare administration, computer science, or a related discipline
- Relevant professional experience may be considered in place of a degree
- Preferred: experience with Medicaid, healthcare, or other health and human services programs
- Preferred: knowledge of Medicaid provider enrollment, screening, revalidation, licensing, affiliations, sanctions, exclusions, ownership, and provider data management
- Preferred: experience supporting an MMIS or another large public-sector healthcare system
- Preferred: experience with OnBase workflows, document management, work queues, e-forms, or related automation capabilities
- Preferred: experience supporting provider-facing portals or online application systems
- Preferred: experience defining requirements for APIs, system interfaces, data ingestion, data validation, and bidirectional integrations
- Preferred: familiarity with NPPES, LEIE, and SAM.gov
- Preferred: knowledge of National Provider Identifiers, provider taxonomy, ordering/referring/prescribing requirements, and provider affiliation structures
- Preferred: experience with identity-management technologies such as Okta, SAML, or comparable authentication solutions
- Preferred: familiarity with ADA and WCAG accessibility requirements
- Preferred: experience supporting state government or federally funded systems-modernization projects
- Preferred: experience with Jira, Azure DevOps, Confluence, Visio, or comparable requirements and process-modeling tools
- Business analysis or Agile certification such as CBAP, CCBA, PMI-PBA, Certified Scrum Product Owner, or equivalent is preferred
Benefits:
- Medical / Dental / Vision Insurance – insurance premium assistance provided
- Additional Insurance (Life, Disability, etc.)
- Paid Time Off
- 401(k) Retirement Savings Plan & Health Savings Account
- Various training courses to promote continuous learning
- Corporate Wellness Program
- Employee-centric culture emphasizing family and healthy work-life balance
- Innovative project exposure and in-house skill development training/courses
- Fortune Fund nonprofit initiatives supporting education and career awareness in rural communities
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