| This position is responsible for researching regulatory material and understanding business processes. Candidate should have some clinical or coding knowledge and an understanding of program requirements, federal regulations, State laws, and change management processes. A good working knowledge of the health care industry, medicare policies and use of the ICD-9 coding as well as awareness of the upcoming ICD-10 coding changes. Candidate must be able to review and create requirements, design, and testing documentation as well as conduct and/or review gap analysis. This individual must be able to anticipate potential problems, develop possible solutions, track problems identified, and participate in all aspects of testing. They must be able to exercise critical and creative thinking when identifying potential problems with business processes, researching/resolving action items, and problems detected in user testing. In addition, this individual must be able to discuss potential solutions with team members and other stakeholders.
This position is responsible for sharing information in various settings. Candidate will interact with other stakeholders and team members to discuss alternative solutions by actively contributing suggestions and sharing information and should be team oriented. Ad Hoc participation in various work groups will be a responsibility as well. |
| Required:
* Experience with health care transactions and code sets such as HIPAA, NCPDP, SL7, ICD-9/ICD-10, etc.
* Experience with Business Analysis methodologies and problem solving
* Knowledge of gap analysis including the ability to conduct an effective gap analysis and then analyse the results
* Experience in solution testing methodologies and hands on experience
* Ability to provide documentation and reports used to evaluate impacts on policies and operations
* Working knowledge of Medicaid and/or MMIS
* Four (4) references will be required prior to consideration of hire
Preferred:
* Bachelor''''s degree in a discipline related to the area of assignment; or equivalent combination of training and experience
* Excellent skills is Microsoft Office Suite including MS Project |
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