Hybrid/Local Healthcare BA (15+) with QA, MS Project, PM, Agile, and CMD and MCS Experience

Job ID: TX-529400720 (99890926)

Hybrid/Local Healthcare BA (15+) with QA, MS Project, PM, Agile, and CMD and MCS Experience

Location: Austin, TX (HHSC)
Duration: 2 Months
Position: 2
Position will be 3 days remote (Mon, Wed, Fri) and 2 days onsite (Tue, Thurs). Program prefers any candidates who are LOCAL ONLY.
Please do not submit candidates who are currently out of state and are planning to move to Texas. Candidates must already reside in Texas.

8 Required Experience in performing complex business analysis and writing technical documentation.
8 Required Experience reporting project status to management including risks, issues, and key decisions.
8 Required Experience identifying project risks and issues; and developing/implementing mitigation strategies.
8 Required Experience in effective general written/oral communication, including documenting requirements, deliverables, test scenarios and project status.
8 Required Experience utilizing business analysis skills and interacting with business end users to gather, validate and document business requirements and translate into technical solutions to satisfy the business needs.
8 Required Experience performing review and approval processes of complex technical user and system requirements written by vendors.
8 Required Experience with Microsoft Office products (Teams, Word, Excel, PowerPoint).
8 Required Experience coordinating and developing test plans/strategies, exit criteria and test scenarios.
8 Required Experience executing detailed test cases within a complex software environment.
8 Required Experience using testing management software.
8 Required Experience with Microsoft Project or similar project management software.
8 Required Experience utilizing the Agile software development methodology.
8 Required Experience as Senior Business Analyst and Agile Product Owner.
8 Required Experience with Medicaid systems and processes.
8 Required Experience in claims processing.
4 Preferred Knowledge of Texas Medicaid programs.
2 Preferred Experience with long term care services.

The Claims Management Division (CMD) within the Medicaid and CHIP Services (MCS) Department is responsible for Long Term Care (LTC) Claims Adjudication through management of the Claims Management System and related support operations.

The Texas Medicaid & Healthcare Partnership (TMHP) contract currently held by Accenture expires on August 31, 2023. HHSC has procured three new TMHP contractors who will operate different contracts performing business operations, claims adjudication and financial service and system maintenance and development activities for state-owned MES systems. Implementing these three new contracts will require technology changes to implement and integrate existing applications with a new claims system to ensure providers are paid, services are authorized, and providers are enrolled.

The prioritized projects that affect LTC claims processing and related systems will be included in Non-COR Amendment 61/ MES Modernization Projects. These technology changes or enhancements to the MES system are required to support successful MES transition, day one claim processing, and critical functionality. Resources will be needed to support these modifications.

The Worker will serve as a senior Business Analyst/Product Owner for the modernization projects. The Worker will be responsible for delivering quality products that meet the state’s desired operational and technical requirements. The Worker will have considerable latitude to use their experience and judgement to ensure successful completion of their assigned tasks. The Worker will be required to multi-task, analyze priorities, communicate clearly, and set expectations for the phases of the project. The Worker will be responsible for communicating with multiple internal and external stakeholders including program and technical staff, and other contracted and vendor resources. The Worker will participate in meetings, track deliverables and schedules, and alert management of any issues that may impact providers.

The services to be provided include, but are not limited to the following:
A. Analyzes program policies, procedures, and processes to determine the impact on business systems and functional areas.
B. Analyzes and reviews system, data, and project deliverables such as business user requirements, design documentation, test plans, and risk assessment plans to ensure business and technical requirements are met.
C. Works with program area staff to solicit, analyze and document business processes and requirements.
D. Acts as a liaison between state staff and vendors to translate operational and business requirements to vendors.
E. Serves as the Product Owner for an agile team, including working with agile/scrum teams of contracted software vendors to implement system changes.
F. Analyzes and writes User Stories with Acceptance Criteria based on business needs and according to the Agile methodology.
G. Develops and maintains business user test scenarios and participates in systems and user acceptance testing.
H. Creates use case scenarios, test plans, and exit criteria that accurately map back to the documented business requirements or user stories.
I. Reviews, analyzes and executes test cases with a formal testing tool.
J. Tracks, documents and reports the status of testing.
K. Evaluates proposed test strategies to ensure appropriate test coverage.
L. Identifies potential project risks and issues and develops mitigation strategies,
M. Reports project status to management on established timelines.
N. Documents action items and business decisions.
O. Conducts meetings and/or presentation tasks as needed.
P. Manages schedule for deliverables as established.
Q. Other duties as assigned related to the MES Modernization project.


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