Hi, I am Joseph a Recruiter with Nuline Systems Inc. I do have a job opening for you as consultant Business Analyst w/Healthcare. If interested please send me your word format resume at joseph@nulinesystems.com
| Position : Business Analyst w/Healthcare Location : Columbus, SC Duration : 12-Months Need Only Green Card Holders and US Citizens |
| | DAILY DUTIES / RESPONSIBILITIES:
The MITA Certification & Compliance Business Analyst for the Replacement MMIS project will be vital in ensuring that the MMIS solutions being implemented will be able to obtain CMS certification according to the Medicaid Enterprise Certification Toolkit (MECT) checklist during the scheduled increments and also after the final implementation has taken place.
In addition, this position will be responsible for ensuring that the MMIS solutions being implemented are meeting all HIPAA, ACA and other CMS Code of Federal Regulations.
Duties include:
1. Develop and coordinate SCDHHSs' business, information and technological certification strategy in detail with CMS prior to publication of any relevant RFPs for the Replacement MMIS related projects;
2. Primary ownership of determining/documenting the process of how certification activities will be performed;
3. Collaborate with the Business Analysts/SMEs, PMs, Process/Technical Integrators and Technical Director to ensure that requirements of the Replacement MMIS related projects would be certification supportable;
4. Primarily responsible for ensuring the certification activities are executed and documented according to the process;
5. Collaborate with IV&V to ensure certification items will be met and other compliancy rules are adhered to;
6. Collaborate with the necessary agency staff (e.g. program directors, ACA) to ensure all Replacement MMIS related projects are compliant with HIPAA, ACA, CFRs, State Medicaid Manual (SMM)
7. Assist Business Analyst/SMEs in their duties when able
REQUIRED SKILLS (RANK IN ORDER OF IMPORTANCE):
• Thorough knowledge/understanding of the Medicaid Information Technology Architecture (version 3.0)
• Thorough knowledge/understanding of the Medicaid Enterprise Certification Toolkit (MECT) checklist
• Thorough understanding of what is a Code of Federal Regulation (CFR), State Medicaid Manual, and a State Plan
• General understanding of Health Insurance Portability and Accountability Act (HIPAA) rules for privacy and all EDI related transactions
• General understanding of the Affordable Care Act
• Excellent research and communication skills
• Strong background and at least six years experience in healthcare insurance business operations (payer or provider side; government or commercial side). Experience in multiple business areas is a plus. Note: IT operations are not the same as business operations.
• At least three years experience in healthcare insurance IT software/systems implementations performing duties described in the "Daily Duties/Responsibilities" section above.
• Ability to properly document business requirements.
• Ability to interpret business process and business data models.
• Ability to correlate validation with processes and data flow and understand relationships
• Ability to examine validation outputs against expected results
• Vendor management experience.
• Superb written and oral communications skills, including the ability to give presentations to executive management. Strong proficiency in English is required.
• Impeccable integrity. This project will have very high visibility and will impact significant expenditures of public funds. Candidates must be confident with their abilities to make correct decisions and the courage to speak out when necessary.
• Willingness and ability to effectively engage with people and organizations on a continuous basis.
PREFERRED SKILLS (RANK IN ORDER OF IMPORTANCE):
• Experience in an outsourced healthcare insurance operations environment.
• Possesses understanding in the areas of application programming, database and system design.
• Understands Internet, Intranet, Extranet and client/server architectures.
• Understands how legacy and web-based systems interface with each other.
• Public sector procurement experience is a plus.
REQUIRED EDUCATION:
Bachelor's degree or equivalent work experience. | | | | DAILY DUTIES / RESPONSIBILITIES:
The MITA Certification & Compliance Business Analyst for the Replacement MMIS project will be vital in ensuring that the MMIS solutions being implemented will be able to obtain CMS certification according to the Medicaid Enterprise Certification Toolkit (MECT) checklist during the scheduled increments and also after the final implementation has taken place.
In addition, this position will be responsible for ensuring that the MMIS solutions being implemented are meeting all HIPAA, ACA and other CMS Code of Federal Regulations.
Duties include:
1. Develop and coordinate SCDHHSs' business, information and technological certification strategy in detail with CMS prior to publication of any relevant RFPs for the Replacement MMIS related projects;
2. Primary ownership of determining/documenting the process of how certification activities will be performed;
3. Collaborate with the Business Analysts/SMEs, PMs, Process/Technical Integrators and Technical Director to ensure that requirements of the Replacement MMIS related projects would be certification supportable;
4. Primarily responsible for ensuring the certification activities are executed and documented according to the process;
5. Collaborate with IV&V to ensure certification items will be met and other compliancy rules are adhered to;
6. Collaborate with the necessary agency staff (e.g. program directors, ACA) to ensure all Replacement MMIS related projects are compliant with HIPAA, ACA, CFRs, State Medicaid Manual (SMM)
7. Assist Business Analyst/SMEs in their duties when able
REQUIRED SKILLS (RANK IN ORDER OF IMPORTANCE):
• Thorough knowledge/understanding of the Medicaid Information Technology Architecture (version 3.0)
• Thorough knowledge/understanding of the Medicaid Enterprise Certification Toolkit (MECT) checklist
• Thorough understanding of what is a Code of Federal Regulation (CFR), State Medicaid Manual, and a State Plan
• General understanding of Health Insurance Portability and Accountability Act (HIPAA) rules for privacy and all EDI related transactions
• General understanding of the Affordable Care Act
• Excellent research and communication skills
• Strong background and at least six years experience in healthcare insurance business operations (payer or provider side; government or commercial side). Experience in multiple business areas is a plus. Note: IT operations are not the same as business operations.
• At least three years experience in healthcare insurance IT software/systems implementations performing duties described in the "Daily Duties/Responsibilities" section above.
• Ability to properly document business requirements.
• Ability to interpret business process and business data models.
• Ability to correlate validation with processes and data flow and understand relationships
• Ability to examine validation outputs against expected results
• Vendor management experience.
• Superb written and oral communications skills, including the ability to give presentations to executive management. Strong proficiency in English is required.
• Impeccable integrity. This project will have very high visibility and will impact significant expenditures of public funds. Candidates must be confident with their abilities to make correct decisions and the courage to speak out when necessary.
• Willingness and ability to effectively engage with people and organizations on a continuous basis.
PREFERRED SKILLS (RANK IN ORDER OF IMPORTANCE):
• Experience in an outsourced healthcare insurance operations environment.
• Possesses understanding in the areas of application programming, database and system design.
• Understands Internet, Intranet, Extranet and client/server architectures.
• Understands how legacy and web-based systems interface with each other.
• Public sector procurement experience is a plus.
REQUIRED EDUCATION:
Bachelor's degree or equivalent work experience. |
| |
Thanks and Regards,
Joseph Adams
Contact: 513-442-4187
Email ID: joseph@nulinesystems.com
www.nulinesystems.com
GTalk : Joseph.recruiter02 : IM : josephadams72
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