Medicaid Claims Processing - BA

Skills:

Medicaid Claims Processing, Business Analysis, Requirements Gathering, Requirements Documentation, Azure DevOps, Wireframing, Agile, Scrum, User Stories, Process Improvement, Gap Analysis, Cost-Benefit Analysis, Workflow Analysis, Functional Specifications, UAT, Systems Analysis, Stakeholder Management, Process Mapping, Data Analysis, SDLC, Business Process Modeling, Healthcare Systems.

We are seeking an experienced Senior Business Analyst to support Medicaid claims processing initiatives and enterprise system enhancement projects. The ideal candidate will have strong experience in business analysis, requirements gathering, process improvement, Azure DevOps, wireframing, and Agile methodologies. This role will work closely with business stakeholders, technical teams, and project leadership to analyze business needs, define system requirements, and deliver effective technology solutions.

Key Responsibilities

• Analyze business processes, operational procedures, and user requirements to identify opportunities for system improvements and automation.
• Gather, document, and validate business, functional, and technical requirements.
• Create detailed business requirement documents, user stories, process flows, and functional specifications.
• Develop wireframes, mockups, and workflow diagrams using Azure DevOps and related tools.
• Conduct gap analysis, impact analysis, and cost-benefit analysis for proposed solutions.
• Collaborate with stakeholders to define project scope, objectives, and deliverables.
• Analyze and document input/output requirements, reporting needs, and data flows.
• Work closely with development, QA, and architecture teams throughout the project lifecycle.
• Support Agile/Scrum ceremonies including sprint planning, backlog refinement, reviews, and retrospectives.
• Facilitate communication between business and technical teams to ensure successful solution delivery.
• Assist with testing, validation, user acceptance testing (UAT), and implementation activities.
• Ensure compliance with organizational standards, policies, and data integrity requirements.

Required Qualifications

• 5+ years of experience in Medicaid Claims Processing.
• 5+ years of experience as a Business Analyst or Systems Analyst.
• Experience gathering, analyzing, and documenting business and system requirements.
• Experience performing process analysis, workflow analysis, and solution evaluations.
• Experience conducting cost-benefit and feasibility analyses.
• Experience creating wireframes and managing requirements in Azure DevOps.
• Strong understanding of Agile and Scrum delivery methodologies.
• Excellent analytical, problem-solving, and critical-thinking skills.
• Strong verbal and written communication skills.
• Ability to work effectively with technical and non-technical stakeholders.
• Knowledge of information technology trends, enterprise architecture, and system design concepts.
• Experience documenting business processes, workflows, and reporting requirements.

Preferred Qualifications

• Experience with Texas DIR Project Delivery Framework.
• Familiarity with information architecture and information management methodologies.
• Experience working on healthcare or government technology projects.
• Knowledge of enterprise infrastructure and software architecture.
• Experience supporting large-scale digital transformation initiatives.