Project Description This multi-year “Modularity” project will include working with multiple vendors. The project must comply with the Center for Medicare and Medicaid Services standards and requirements such as the Medicaid Information Technology Architecture (MITA) and Streamlined Modular Certification (SMC). To support this effort, the AMA is seeking an experienced Business Process Analyst (BPA) to be a member of the Medicaid Enterprise Systems (MES) team. The BPA’s primary roles will be to work with Agency stakeholders and contract vendors to; 1) understand Alabama Medicaid policies and procedures from the State Plan through multiple vendors to claims payment 2) identify and update all of Alabama Medicaid policies and procedures documentation 3) recommend processes to automate future updates to the policies and procedures documentation and 4) develop a process to keep the Medicaid policies and procedures documentation updated on an ongoing basis. Must work normal 8:00 AM to 5:00 PM hours on-site in Montgomery AL. Skills Required - Able to work with agency personnel and contract vendors to locate and gather source data required to build out policies and procedures documentation
- Able to work with agency personnel and contract vendors to map out an “as is” and suggested “to be” process for maintaining policies and procedures documentation
- Must understand claims processing and validate that the claims processing supports the Agency’s policies and procedures
- Develop a method to track policies through Agency documentation
- Validate those policies and procedures are supported by Agency documentation
- Interpret written policy into a set of pre-defined spreadsheets
- Must have good interpersonal and communications skills, report writing abilities and an aptitude for analyzing data
- Must be proficient with spreadsheet software and flow-charting tools e.g. Visio
Skills Preferred - Strong interpersonal skills to build team rapport
- Excellent verbal and written communication skills
- Ability to work independently with minimal direction from State or other team members
- Ability to work under pressure / to a deadline
- Strong analytical and critical thinking skills
- Exceptional research and reporting skills.
Experience Required - 3-5 Years of experience as a Business Process Analyst
- 2-3 years of experience with multi-vendor projects
- 3-5 years of experience on Medicaid, Medicare or Commercial Health Care Payer projects with a strong emphasis on benefit plans
- 3-5 years’ experience facilitating and/or assisting with documenting and publishing policies and procedures manuals
- Expert/Advanced knowledge of all Microsoft Office products including MS Project, SharePoint and Visio
Education Required - Bachelor of Arts or Bachelor of Science degree. Equivalent work experience may be substituted for a degree.
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