face to face after phone interview. No expenses paid.
Location: Boston, MA
Duration: 3-6+ months
Rate: $45 per hour Max.
Title/Role: Business Analyst.
The following are two items that the candidate MUST have a lot of experience with:
- Claims and Adjudication
- Medicare and Medicaid
Project: Implementation of a dual eligible product. This involves members who are eligible for both Medicare and Medicaid. The project is complex and includes designing a new Care Model, identifying new IT tools to support the new Care Model, defining the requirements for operational units (enrollment, claims, customer service, sales & marketing) and working with both CMS (for Medicare) and Commonwealth of Mass (for Medicaid) to identify regulatory and operational requirements.
Role: The business analyst will be working with multiple business units and the project team to identify the operational processing requirements for this new product. The work will include detailed documentation of current state, work with other analysts to understand new processing requirements, analysis of existing system (Diamond) and analysis to determine operational impact of implementing the required new processes. The individual would need to coordinate with other project teams, the IT PM and the senior project manager who is coordinating all areas. Familiarity with Medicare Advantage and Medicaid would be helpful.
Skills:
- Strong analytical skills including the ability to work with both operational and technical resources.
- Detailed knowledge of the claims adjudication process within a healthcare payer or provider environment
- Excellent documentation abilities to capture both current state and new requirements. Ability with MS VISIO and other documentation tools.
- Requires ability to work with project management techniques, tools and methods and the use of MSProject and MSOffice suite of products
- Experience with operational processes in a managed care environment. This includes enrollment, claims processing and customer service.
- Requires well-developed verbal and written communication skills, and strong facilitation skills.
Experience:
Highly skilled Analysts with a minimum of 5 years experience in developing requirements in a managed care or other health care environment.
Gopal
MetaSense, Inc.
NJ Minority Certified Company
100 Technology Way, Suite 320
Mt. Laurel, NJ 08054
Fax: (856) 475-0555
gopal@metasenseusa.com
MetaSense Inc. is a Professional Services, Staff Augmentation, Web Design, Call Center, BPO Company with offices located in Mt. Laurel, NJ. MetaSense specializes in the delivery of cost effective, high-value Information Technology and Business Solutions since its inception in 1999.
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