Please do not reply without the skills "mapping"
Sr. BA - Q/A
4 months Contract
Downtown Minneapolis, MN:
Non-local ok. Phone hire ok.
Could you please 1) give a brief statement and/or 2) list years of experience with each of the required and desired skills below?
Skill Sets Needed:
• Six plus years as a Senior Business Analyst in the health care claims processing.
• Must have applicable QA claims health care experience for 2 – 3 years.
• Experience in working with claims accumulators that cross apply to medical and pharmacy benefits.
• Understanding of Medicaid & Medicare benefits is preferred
• Strong analytical and technical skills
• Good verbal and written communication
• Prior experience with back office functions, government programs and/or the Facets product preferred
• Experience with the implementation of healthcare operations software solutions
Business Need
Client's business will have additional business in place starting 1/1/2016. The expansion work includes a product implementation that requires Client to document business requirements for system requests and system configuration that will need to be implemented by Client's delegated vendor. The business requirements that need to be documented are for new benefits, claim accumulators (between medical and the PBM), networks, provider contracts, and enrollment changes. To support this implementation Client requires a Senior Business Analyst/Quality Analyst position to support the documentation of business requirements, documenting the business acceptance test plan, develop test cases, and develop test timelines with the Client Project Manager in partnership with the delegated vendor.
Description of Work to Be Performed and the Specific Skill Sets Needed:
Roles and Responsibilities:
The Senior Business Analyst will provide business analysis and quality assurance services implementing a new product with Client's delegated vendor that is accountable to for claims processing on behalf of lient. This position would take work direction from the Client Project Manager.
In conjunction with other technical staff on the project team, work could include:
Business Analysis
• Build process flows and procedures, review existing documentation and define the Gaps. Complete updates to existing documentation to fill gaps.
• Document any current operational gaps and incorporate changes to future operations if applicable
• Aligning the Integrated project plan with Client and all of their vendors / partners
• Develop future state recommendations and vendor/management oversight toolkit.
• Research and develop processes for implementation and oversight.
• Identify, analyze, document, communicate and validate requirements for changes to our core and supporting software products and business processes.
• Provide support, as necessary, for internal audit and impacts related to outsourcing Medicaid claims processing.
Quality Assurance
• Develop test plan with business areas and delegated vendors
• Develop and execute test cases
• Create and maintain test data
• Document test results and track defects
Skill Sets Needed:
• Six plus years as a Senior Business Analyst in the health care claims processing.
• Must have applicable QA claims health care experience for 2 – 3 years.
• Experience in working with claims accumulators that cross apply to medical and pharmacy benefits.
• Understanding of Medicaid & Medicare benefits is preferred
• Strong analytical and technical skills
• Good verbal and written communication
• Prior experience with back office functions, government programs and/or the Facets product preferred
• Experience with the implementation of healthcare operations software solutions
List of Deliverables, e.g. what the consultant(s) will be expected to accomplish: ¬
• Regular status reports
• Identification and estimation of BA tasks for the overall project plan
• Business requirements
• Follow issue management process and manage it in cooperation with project management
• BA documentation created/utilized in the project
• Other project documentation, as assigned
• Active project team member
• Business Acceptance test plan, test cases, controlled release plan as we release claim in production
• Adherence to Client Non-discrimination and Respectful Workplace policy
Impact/Outcome from a Business Perspective:
Claims are processed correctly for health clients.
Thanks & Regards,
Rani Adari
Tech Tammina
203 Elden Street
Herndon, VA-20170
Call: 703-880-4992
Fax: 703-991-5532
rani@tammina.com
www.tammina.com
GTalk:raniadarii
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An ISO 9001:2008 Certified Company
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