14 days old

Business Analyst (MassHealth Payment)

Quincy, MA 02171
  • Job Code
  • Payrate
    $25 To $28

Business Analyst - MassHealth Payment Reform Operations

The Functional Business Analyst (FBA) is responsible for coordinating with Subject Matter Experts (SME), MassHealth vendors, and technical staff to support the implementation of key MassHealth initiatives. These initiatives are primarily comprised of state and federal mandates. The BA's responsibilities include but are not limited to the participation, from a business perspective, in all levels of the system development life cycle to implement and operationalize HIPAA transactions and other related initiatives as required. This includes validating HIPAA and other key business requirements, coordinating with agency staff to leverage industry standard tools to research and resolve issues, and to support the post implementation stabilization of agency initiatives.

Major Responsibilities

  1. Evaluate state and federal mandates to identify and validate the impact of the initiative on the HIPAA transactions; This includes creating summary materials and supporting documentation to process the proposed changes with SMES, agency vendors, and technical staff as required
  2. Participate in industry forums (CMS, CAQH CORE) to stay abreast of upcoming mandates and current state; develop summary reports, as required, to communicate the status of industry initiatives
  3. Participate in Joint Application Design (JAD) sessions to validate business requirements; assist with tracking & resolution of related issues as required; review and validate the related Business Requirements Document (BRD)
  4. Participate in project team meetings to develop, review, validate, and execute against approved implementation and stabilization plans; this includes, but is not limited to the validation of escalation procedures, go-no-go criteria, cut-over activities, contingencies and risks, critical implementation & operational readiness activities, as well as processes to monitor and stabilize operations post implementation (e.g. monitor defects, transition to operations)
  5. Review and validate test cases and participate in User Acceptance Testing (UAT) as required; monitor and coordinate related issues with SMEs and IT as required; this includes defect monitoring through resolution
  6. Where applicable, evaluate implementation related business documentation (e.g. Companion & Billing Guides, communication materials, web pages) to ensure concepts and content is accurate and reflective of the current state of the initiative. This also include the review of the ASC X12 Implementation Guides to research issues and to address compliance questions as required
  7. Support the development of status reports and related monitoring materials; maintain reporting as required
  8. Support the development, implementation, and monitoring of Trading Partner Testing (TPT) plans and approaches
  9. Utilize all standard project tools (i.e. Mass Forge, MMIS Knowledge Center, Microsoft Project, Word, email, scheduler , Visio, Excel, Power point etc.)
  10. Facilitate, lead, participate in, and support other related project meetings and activities as required

Key Qualifications:

Demonstrable experience with ASC X12 V5010 HIPAA transactions and related trading partner testing

Demonstrable experience working on large systems projects that required the coordination across multiple work streams and stakeholders

Demonstrable experience with participating in the actual implementation (delivery) of a large technical initiative

Experience with navigating through large dynamic organizations and the ability to clearly and concisely convey complex business and technical concepts and issues


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Business Analyst (MassHealth Payment)

Randstad Technologies
Quincy, MA 02171

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Randstad Technologies
Quincy, MA

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