Business Analyst/Healthcare Business Rules Subject Matter Expert (SME) with medicaid, MMIS and MITA experience

Business Analyst/Healthcare Business Rules Subject Matter Expert (SME) with medicaid, MMIS and MITA experience

Location: Columbia SC

Positions: 3
Duration: 12 Months

The Healthcare Business Rules Subject Matter Expert (SME) position is responsible for gathering, analyzing, and documenting business rules as well as working with development, test, and business operations teams to ensure accurate implementation of those business rules. The majority of the effort will support the Replacement MMIS program; however, support of other projects is likely, as well.

Duties include:
• Gathering business rules, business terminology (noun concepts), and relationships (verb concepts) associated with a State Medicaid program from laws, regulations, policies, and standard practices. This will involve substantial work with subject matter experts (SMEs) representing the program and the business.
• Analyzing business rules and related artifacts for completeness, consistency, and accuracy.
• Documenting business rules and related artifacts using standardized, formal methodologies with high accuracy and efficiency.
• Working with business users to identify and manage changes to the business rules.
• Coordinating with technical implementation teams to identify the correct business rules to be implemented and ensuring that the system implementations execute those rules accurately as intended.
• Participating with test teams and Independent Verification & Validation personnel to ensure that the verification and validation procedures will adequately evaluate rules implementation.
• Evaluating the accuracy in which manual business processes interpret and execute business rules.
• Other duties as assigned.

• At least 5 years of experience in Healthcare IT development and/or business operations. This experience should be of sufficient depth such that the candidate could reasonably be considered a subject matter expert in one or more Healthcare insurance business domains.
• At least 2 years of experience in Medicaid policy or business rules
• Understanding of business rules and how business rules are used.
• Ability to extract business rules and other related information from documents and personnel interviews.
• Ability to interpret business process and business data models.
• Superb written and oral communication skills, including the ability to give presentations to executive management. Strong proficiency in English is required
• Impeccable integrity. This project has very high visibility and represents a significant expenditure of public funds. Candidates must be confident with their abilities to make correct decisions and the conviction to speak out when necessary
• Willingness and ability to effectively engage with people and organizations on a continuous basis

• Experience documenting business rules using a structured methodology.
• IT modeling experience.

Bachelor Degree preferred.

Background Checks:

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