Location: COLUMBIA, SC (In-person Interview may be required)

Postions: 1

Duration: 6 months

The client seeks expert in Business Analysis to serve as primary analyst to define business requirements and business process and policy changes related to the client Medicaid system during the conversion from the existing HIPAA 4010A formats to the future HIPAA 5010A format, which is required by CMS on January 12, 2012.

Individual must possess the following:

•             Business Analysis experience in a health care delivery system

•             Bachelor’s degree and 5 or more years experience in business process

analysis/re-engineering working with business clients and technical staff to develop business requirements for implementation of computer applications.

•             Two years experience in a Medicaid or Medicare agency or commercial

health/casualty insurance organization working directly with HIPAA Transactions and Code Set Rule.

•             Must be able to work independently within guidelines, developing and

executing test scripts, test cases, data sets and user procedures.

•             Must have strong organization, planning, problem solving, and

decision making skills, and be able to prioritize and manage multiple tasks simultaneously.

•             Must work well within a team environment and have exceptional

collaborative skills.

•             Must be service oriented with strong interpersonal skills with all

levels of business and technical staff.

•             Must have good overall PC skills including the use of Microsoft

Office products

•             Must be a self-starter and self-motivated. Must be able to quickly

learn and apply new technology.

•             Excellent written and verbal communication skills

•             Ability to effectively work and communicate, in both oral and

written, with all levels of the Agency from frontline workers to Executive Staff as well as the Contractor(s)

•             Independent and deadline-oriented, with ability to translate broad

and complex concepts to diverse audiences.

•             Knowledge of MMIS is preferable

Scope of Work:

•             Gain understanding of the client policy and billing requirements and

document needed changes to policy and billing manuals related to HIPAA 5010, through facilitation with internal the client program areas.

•             Analyze and document Medicaid EDI transactions issues related to

implementation of HIPAA 5010 and ensure these issues are documented and addressed in the approach to th the HIPAA 5010 version.

•             Analyze and document HIPAA 5010 requirements related to data

elements, data exchange and data transmission to the client stakeholders

•             Incorporate a vendor management plan in strategic planning to

include a vendor impact analysis to document how each vendor is affected by HIPAA 5010 and create approach to address these vendor issues

•             Document business needs for the HIPAA 5010 gap analysis

•             Information gathering during requirements activities must be

translated into a comprehensive requirements document to be used by Clemson University to develop the system approach to HIPAA 5010

•             Determine needed HIPAA 5010 training for both internal staff and

Medicaid provider groups, and assist in the development of training materials

•             Other related duties as assigned

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