Category: Uncategorized

MetroPlus Health Plan provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlus network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlus has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.

Position Overview

Reporting to the Director, Medicaid the Operations Analyst will play a critical role in supporting operational excellence and regulatory compliance across all Medicaid products. The analyst will provide analytical and project management support to the Director to ensure prompt follow-up and timely completion of projects.

Clipped from: https://www.jobs2careers.com/r/job/14985219422?aff_id=5802&dest=https%3A%2F%2Fwww.jobs2careers.com%2Fclick.php%3Fjid%3D39b0e554ddcd57e9a9660b124%26cri%3D0%26js%3D0%26pv%3D1%26is_adv_only%3D1&click_time=2021-02-01+09%3A27%3A31&tlr_sid=dde17dfa9fafa3d7

KPMG is currently seeking a Manager in State and Local Government for our Consulting practice.

Responsibilities:

Support and deliver large, complex public services and state/local government engagements that identify, design, and implement creative business and technology services for state/local government clients

Engage projects as a Business Analyst Subject Matter Professional

Lead your team to produce related project deliverables on a scheduled basis and also produce project deliverables yourself

Manage the day-to-day deliverables with assigned team members

Develop and execute methodologies and solutions specific to the public sector and state/local government industry

Qualifications:

Minimum of five years of experience in the Health and Human Services Medicaid solution delivery market, working for a commercial COTS solution provider or consulting organization with a minimum of five years of experience managing large, complex technology projects on the scale of a State Medicaid MMIS solution

Bachelors degree from an accredited college/university in technical sciences or information systems

Must have served in a team lead role on at least (1) MMIS implementation and (1) MMIS M&O engagement in a Functional Requirement teams and demonstrated experience as a team lead of 5-7 staff, including staff from diverse organizations to successfully implement and operate technology-based solutions

Hands-on experience with the Center for Medicare and Medicaid Services (CMS) Medicaid Information Technology Architecture (MITA), Medicaid Certification Lifecycle, associated toolkit and CMS checklists

Business Analyst professionals should have 4+ years of demonstrated Medicaid knowledge with MMIS modules including claims processing, finance, pharmacy, provider, TPL, managed care

Capable of presenting Medicaid topics to large, varied audiences in either written or verbal presentation format and experience in working on customer proposals or deal capture teams in the State Medicaid market

Clipped from: https://wtaelocaljobs.com/jobs/manager-state-and-local-business-analyst-harrisburg-pennsylvania/222725592-2/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Resp & Qualifications Lead IT Business Analyst, Medicaid Solutions We are looking for a talented Lead Technical Business Analyst to join the revolution in health care IT We are working on “the big picture” of the future of health care information technology and what we do touches the lives of millions of people. Today, we are looking for a multi-talented Lead Business/Systems Analyst who wants to make a difference; be change-maker, while working together to build a leaner approach to business solutions through technology and really make an impact on our Medicaid Solutions team and our success. At CareFirst BlueCross BlueShield, you will have the opportunity to influence the direction of health care by participating at an expert-level with the feasibility of the most complex enhancements, automations and implementations review, analysis, and evaluation of current and future business processes. Explore alternative business solutions – is liaison to business/IT/Shared Services to explain choices and implications – works closely with system analyst to help create POCs and alternative solutions to create, maintain and enhance business value. Develop solutions that solve the most complex technical and/or business issues. Ideally, you will bring experience managing and facilitating JAD sessions, expertly gather and prioritize systems requirements and proactively identify various opportunities and enhancements with specific healthcare payer-side authorization, claims adjudication, etc. while independently leading or participate in all phases of the software development life cycle, with focus on defining the underlying business needs, documenting those needs, validating conceptual systems designs, and assuring delivery quality through comprehensive testing and training. PRINCIPAL ACCOUNTABILITIES: * Lead and participate at an expert-level with the feasibility of the most complex enhancements, automations and implementations review, analysis, and evaluation of current and future business processes.
* Explore alternative business solutions – is liaison to business/IT/Shared Services to explain choices and implications – works closely with system analyst to help create POCs and alternative solutions to create, maintain and enhance business value.
* Develop solutions that solve the most complex technical and/or business issues.
* Proactively identifies opportunities and enhancements. Independently lead or participate in all phases of the software development life cycle, with focus on defining the underlying business needs, documenting those needs, validating conceptual systems designs, and assuring delivery quality through comprehensive testing and training.
* Analyze define and interpret business needs and issues by gathering, analyzing, documenting, and validating the Business area(s) and user(s) technical (functional/non-functional) requirements.
* Create PRD (Project Requirements Document) for most complex enhancements, automations and implementations including defining Business, User and functional and non-functional requirements needed for approval by Business and for use by Design, Development and Testing teams.
* Create Requirements Management Plan to define, organize and schedule requirements management and development activities. Lead requirements analysis and verification sessions. Produces Requirements Traceability Matrix (RTM) and RTM gap analysis reports.
* Track and manage open issues and plan for resolution. Troubleshoot systems problems, identify cause of problems, work with appropriate group to correct problem. Maintain communications with technical counterparts to guide the issues to cross-functional resolution and adopt best practices and ensure integration of specific application architecture into overall enterprise technology strategy.
* Lead testing efforts by defining, developing, and implementing practices and procedures for complete end user test plans. Ensures all tests are conducted and documented according to standards. Identifies and documents system deficiencies and recommends solutions.
* Responsible for overall success of testing, including results verification and release. Coordinates groups of end users who test, evaluate, and validate new functions and applications and identify issues in software or services to ensure continuing operational quality by documenting fixes and enhancements. Providing guidance and training to application end users. Provides ongoing assistance to software developers and testers to resolve defects during the testing process. Leads development sessions and design reviews to ensure design meets user requirements.
* Reviews, edits, analyze and create detailed documentation of business systems and user needs. Responsible for writing all documentation in clear and well-organized manner including SOPs and training manuals.
* Use project management techniques to establish roles and responsibilities, monitor project and request status and workload, and ensure deliverables of high quality, effectiveness, and timeliness and manage assigned enhancements, automations, and implementations from concept through implementation. Creates, develops, and maintains project schedules for key deliverables by developing project plan, monitoring milestone completion, and coordinating project progress. Develops key project deliverables including requirements specifications, use cases, system test cases, training and documentation and user manuals for the most complex enhancements, automations, and implementations. Manages the sequencing of releases to meet business needs. ADDITIONAL KNOWLEADGE, ABILITIES & SKILLS: * Relevant business and systems subject matter expertise with the ability to work independently and as part of a team ad have excellent interpersonal skills including the ability to build consensus and agreement and bring resolution to contentious issues and entrenched interests.
* Have proven ability to lead problem-solving discussions with attention to detail and excellent analytical and problem-solving skills, advanced written and verbal communication skills, excellent organizational skills, and ability to set priorities and handle multiple projects concurrently.
* High level of analytical and problem-solving skills with extensive PC skills including Microsoft office software such as Word, Excel, VISIO and Power Point and experience in accurately modeling requirements using at least one if not more of the following: Functional Decomposition, Data Flow Diagrams, User Context Diagrams, Activity Diagrams, Decision Needs, Workflow modeling, Use Cases, Use Case Model Survey and Use Case Specification, Process Modeling, Prototyping
* Demonstrated leadership skills.
* Experience with coaching, mentoring, and providing feedback to associates as well as leading small teams of junior analysts. BASIC QUALIFICATIONS: * This position requires a bachelor’s degree in Information Technology, Computer Science or Business or relevant work experience in business analysis, systems analysis and/or testing background and 6+ years of direct Business Analyst experience
* Experience in business process analysis, Workflow, task analysis, user acceptance testing and requirements analysis with proven ability to elicit, document, analyze and verify requirements.
* Strong experience with user acceptance testing concepts, proven ability to work well as a team, demonstrated ability to lead problem solving business/technology teams and projects, have technical writing experience and training experience.
* Minimum of 4 years of demonstrated successful use of SDLC methodology or demonstrated knowledge of business processes related to the business area supporting and must demonstrate understanding of industry standard Business Analysis Best Practices. PREFERRED QUALIFICATIONS: * Knowledge of organization and operations of the business area supporting and understands basic Internet and client/server architectures.
* BA certification with experience using Requirements Management tools, experience in the healthcare insurance industry, especially BCBS plans.
* Experience with software testing, test management and defect tracking tools. Equal Employment Opportunity CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information. Hire Range Disclaimer Actual salary will be based on relevant job experience and work history. Where To Apply Please visit our website to apply: ~~~/careers Closing Date Please apply before: 1/10/2021 Federal Disc/Physical Demand Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs. PHYSICAL DEMANDS: The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted. Sponsorship in US Must be eligible to work in the U.S. without Sponsorship

Monday, February 1, 2021

8:27 AM

Clipped from: https://www.baltimorejobsite.com/jobs/search?id=1399793500&tx=VZ6073TTZ&pt=1&aff=3303BC1B-C50D-4D0E-A438-CA40C53942FA&utm_source=Job+Feed&utm_medium=tideri&utm_campaign=LU&utm_term=3303BC1B-C50D-4D0E-A438-CA40C53942FA&txo=UU5266TTZ&rgv=3&mlp=1

BASIC FUNCTION:

This position is responsible for providing operational services, assistance and program implementation and coordination for one or more of the day-to-day Medicaid operation functions (e.g. program implementation, member communications and auditing) This resource is responsible for resolving complex and / or escalated internal or external operational questions. Additionally this position works with other areas of the organization on the development, testing, and implementation of program policies, business processes, and system changes to ensure the state requirements of the plan are met.

JOB REQUIREMENTS:

• Bachelor Degree in Business with 4 years experience OR 8 years experience working in health insurance operations.
• Experience in project development, implementation and execution skills.
• Experience interfacing with internal clients, Marketing/Sales management and operations personnel.
• Verbal and written communication skills and ability to represent Medicaid department at committee meetings.
• Experience with interacting effectively with all levels of internal and external customers.
• Experience managing multiple projects effectively.
• Interpersonal, organizational and analytical skills.
• Organizational and leadership skills.

PREFERRED JOB REQUIREMENTS:

• Experience with managing contract provisions.
• Experience in Project Management.
• Presentation and group facilitation experience
• PC proficiency to include Word, Excel, PowerPoint.
• Strong written and verbal communication skills

This role will be based out of the Richardson office, once it has re-opened.

Location: TX – Richardson

Activation Date: Wednesday, January 27, 2021

Expiration Date: Thursday, February 11, 2021

Clipped from: https://workintexas-veterans.jobs/richardson-tx/medicaid-operations-specialist/479AC00124F345B09AF7905256D5DD14/job/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Found in: Jooble US Premium

Description:

CSG Government Solutions is a national leader in planning, managing and supporting complex projects that modernize the information technology and business processes of large government programs. For more than 20 years, we have applied our expertise, innovation, and results-oriented mindset to the most complex program modernization projects of over 150 government and other organizations including 44 state governments, the U.S. Department of Health and Human Services, the U.S. Department of Labor, and large municipal governments. CSG provides multiple service offerings to our valued clients. PMO by CSG brings all the expertise and experience needed to establish and operate a rdquofull-servicerdquo PMO. IVV by CSG provides independent insight into all aspects of a project, with a focus on risk identification, analysis, and mitigation. QA BY CSG deploys highly experienced teams and innovative methods, knowledge, and tools to assure that complex projects achieve our clientrsquos objectives. Strategy BY CSG brings our high-value resources to provide insight into best practices CSG is seeking business analysts with 3+ years of Medicaid and MMIS experience to join our consulting staff. You will work on highly productive project teams delivering our services to state government agencies nationwide. The responsibilities and qualifications are as follows Responsibilities and Qualifications include Working as member of a project team functioning as a business analyst for large-scale technology projects utilizing agile methodologies Facilitating the elicitation and documentation of business requirements and joint application design sessions Reviewing functional and technical requirements and design specifications Analyzing business processes and workflows Conducting quality reviews of design documents Conducting quality reviews of test plans and procedures Analyzing requirements traceability throughout the system development life cycle Facilitating the development of test scripts and test data necessary for performing user acceptance testing Creating project documentation including meeting minutes, deliverables, project status reports and presentations Tracking issues, risks, action items and decisions using standard project management techniques and tools Communicating project issues and risks to the project management team Familiar with MMIS Certification Process, a plus Experience with MMIS modularity is a plus Experience with Medicaid Enterprise Checklist Toolkit (MECT) framework, a plus Experience with MMIS planning, procurement, andor operations, a plus Knowledge of Medicaid Information Technology Architecture (MITA), a plus Travel may be necessary under normal circumstances. Must be able to work remotely in a productive manner if the COVID-19 situation limits travel. Assistance with relocation may be an option in certain circumstances. All candidates authorized to work in the US without sponsorship are eligible to apply Working at CSG Clients trust us with their most difficult challenges, so we have to be at the top of our game. And you will be, too. Yoursquoll also find that wersquore able to keep it in perspective, combining a strong work ethic with an appreciation for a balanced life. Itrsquos a team atmosphere, where dedicated professionals with complementary talents encourage one another to do their best work in an environment focused on integrity, growth, and excellence. These are just a few of the many reasons why CSG has been named one of Americarsquos Best Management Consulting Firms three years in a row by Forbes Magazine. Our Focus on Professional Development Wersquore dedicated to the personal growth of our employees and have programs that enable you to enhance your skills and pursue your career goals within our company. Our Professional Development group works with you to develop an individual Professional Development Plan (PDP) that aligns your goals with the skills we need to deliver the highest quality services to our clients. Your PDP addresses staffing assignments, training and other factors that keep you on the path to a rewarding career. Our training program, The CSG Way, is focused on continuously developing the skills of our employees and sharing knowledge across our organization. The program includes courses that develop your analytical, management, and leadership skills expand your program knowledge and prepare you for project assignments. Benefits Competitive Benefits including Medical and Dental Insurance, Life Insurance, Short-Term and Long-Term Disability Insurance, 401k with employer match, Paid Vacation and Holidays For more information about CSG Government Solutions visit CSG Government Solutions is an Equal Opportunity Employer. MFDV

Clipped from: https://us.trabajo.org/job-527-7bebf8b4490e54a1c42189194842f65f?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic