Senior Business Analyst

NTT DATA North America is a business and technology services company. It is seeking a Senior Business Analyst to support Medicaid Third Party Liability business operations, system and process changes, requirements gathering, testing, implementation, and operational improvement for a state Medicaid program.

Responsibilities

Analyze Medicaid claims, TPL workflows, Medicare Crossovers (Pt A&B), Medicare Advantage (Pt C), and recovery data to identify trends, root causes, and opportunities for cost avoidance and recovery optimization

Translate federal/state TPL policies into system requirements

Support MMIS enhancements, including adjudication rules and edits, reporting, letters, etc

Work with vendors and state stakeholders to improve all faucets of insurance discovery and recovery processes

Lead requirements gathering, documentation, create and conduct UAT testing

Identify and report issues, risks, and dependencies

Support issue triage, backlog management, and operational reporting for day-to-day TPL activities

Preferred

Experience translating Federal and State regulations into working requirements that are actionable by technical teams

Experience working with Medicaid Enterprise Systems (MES) vendors

Ability to translate between non-technical business users and technical IT resources

Strong SQL and data analysis skills

Strong understanding of HIPAA and X12 EDI standards

Federal Regulations

State Regulations

Medicaid Enterprise Systems

MES Vendors

SQL

Data Analysis

HIPAA

X12 EDI Standards

Business-Technical Translation

Actionable Requirements Translation

Benefits

Medical insurance with an employer contribution

Dental insurance with an employer contribution

Vision insurance with an employer contribution

Flexible spending or health savings account

Life and AD&D insurance

Short and long term disability coverage

Paid time off

Employee assistance

Participation in a 401k program with company match

Additional voluntary or legally-required benefits

Remote or hybrid work options, subject to change based on client requirements

Company

Business and technology consulting, AI, and IT services.

Plano, Texas, USA

https://us.nttdata.com/

Founded in 1988

10001+ employees

Qualifications

Minimum 6 years of experience supporting large, complex Medicaid system implementation projects and/or Medicaid business operations

Minimum 6 years of experience with TPL, Coordination of Benefits, Medicare Crossover Part (A&B) Claims processing, Medicare Advantage (Part C), claims workflows, including complex claim scenarios and regulatory compliance

Minimum 6 years of experience with elicitation and verification of business and technical requirements

Minimum 3 years of experience with system development methodology and project management principles

Minimum 3 years of experience conducting reviews of system development life cycle documentation, project and technical architecture and design deliverables/artifacts

Candidate must be local to the client in Little Rock, Arkansas

Undergraduate degree or 4 years relevant experience

Experience translating Federal and State regulations into working requirements that are actionable by technical teams

Experience working with Medicaid Enterprise Systems (MES) vendors

Ability to translate between non-technical business users and technical IT resources

Strong SQL and data analysis skills

Strong understanding of HIPAA and X12 EDI standards

Minimum 6 years of experience with TPL, Coordination of Benefits, Medicare Crossover Part (A&B) Claims processing, Medicare Advantage (Part C), claims workflows, including complex claim scenarios and regulatory compliance.

Required skills

Represents the skills you have, click on the tags, Medicaid Third Party Liability (TPL), Medicaid Management Information Systems (MMIS), Medicaid Claims Processing, Coordination of Benefits (COB), Medicare Crossover Claims (Parts A & B), Medicare Advantage (Part C), Medicaid Recovery Operations, System Development Life Cycle (SDLC), HIPAA and X12 EDI Standards

Preferred skills

Strong SQL and data analysis skills, Strong understanding of HIPAA and X12 EDI standards

Experience

6+ years