Technical Business Analyst

Key Responsibilities

Federal Reporting & Compliance Analyze and interpret CMS, Medicaid, and state reporting requirements. Support T-MSIS, CMS-64, CMS-37, PERM, and other federal reporting initiatives. Ensure MMIS reporting processes comply with federal and state regulations. Monitor reporting changes and assess business and system impacts.

Business Analysis Gather, document, and manage business and functional requirements. Create BRDs, Functional Specifications, User Stories, and Process Flows. Conduct gap analyses and impact assessments for regulatory changes. Establish traceability between requirements, testing, and implementation. Data Analysis & Validation Perform data validation, reconciliation, and quality assurance activities.

Analyze claims, provider, member, encounter, and financial data. Identify data anomalies and work with technical teams to resolve issues. Validate report accuracy prior to submission. Stakeholder Management Serve as the primary liaison between State Medicaid agencies, business users, reporting teams, and IT. Facilitate requirements workshops, reviews, and stakeholder meetings.

Present reporting findings, risks, and recommendations to leadership. Testing & Implementation Support Develop and execute test scenarios for reporting enhancements. Support SIT, UAT, regression testing, and production validation. Review defects, perform root cause analysis, and validate fixes. Support release planning and deployment activities.

Operational Support Support monthly, quarterly, and annual federal reporting cycles. Assist with audit requests and compliance reviews. Create operational procedures, SOPs, and reporting documentation. Support production issue analysis and resolution. Required Qualifications Bachelor's degree in Business, Healthcare Administration, Information Systems, or related field.

5+ years of Business Analyst experience. 3+ years of MMIS or Medicaid experience. Strong knowledge of Medicaid claims, providers, members, financials, and encounters. Experience with federal reporting programs such as T-MSIS, CMS-64, CMS-37, or PERM. Experience creating BRDs, Functional Requirements, User Stories, and test cases.

Strong SQL and data analysis skills. Experience working in Agile and/or Waterfall environments.

Preferred Qualifications

MMIS modernization or O&M experience. Knowledge of healthcare EDI transactions (837, 835, 270/271, etc.) Experience with Cognos, Power BI, Tableau, or reporting tools. Experience supporting CMS audits and certification activities. CBAP or PMI-PBA certification preferred. Key Skills Federal Medicaid Reporting T-MSIS Reporting Regulatory Compliance Requirements Management Data Analysis & Reconciliation SQL Defect Management UAT/SIT Testing Stakeholder Communication Documentation & Reporting Root Cause Analysis Success Measures Timely and accurate federal report submissions.

Compliance with CMS and State reporting requirements. Improved data quality and reporting accuracy. Successful implementation of reporting enhancements. Positive stakeholder and client satisfaction.