Job Description
*Teleworking opportunity is available. Will be required to come into the office once per week*
The Texas Health and Human Services (HHS) Medicaid & CHIP Services (MCS) department seeks a highly qualified candidate to fill the position of Business Analyst III (BA III) in the Operations Management Claims Administrator (OMCA) Daily Operations unit. OMCA Daily Operations manages a suite of Medicaid Management Information Systems (MMIS) that are utilized by clients and providers to submit claims, encounters, prior authorizations, enroll in Medicaid, view Client health information, and verify client eligibility.
The BA III reports to the Daily Operations manager and serves as a Product Owner (PO) for the Daily Operations program. Activities for this position include working with agile/scrum teams of contracted software vendors to implement system changes; performing analysis of systems and business processes to ensure alignment with business operations; overseeing and coordinating development of business requirements; performing project management tasks; leading and/or participating in external stakeholder discussions to provide and track feedback on upcoming system requirements.
This position will assist with ensuring the Medicaid Managed Information Systems (MMIS) meet agency and HHS stakeholder directives, plans, goals, and contract requirements for Medicaid/CHIP programs including, but not limited to Acute Care.
Works under minimal direction with considerable latitude for the use of initiative and independent judgment.
The Texas Health and Human Services (HHS) Medicaid & CHIP Services (MCS) department seeks a highly qualified candidate to fill the position of Business Analyst III (BA III) in the Operations Management Claims Administrator (OMCA) Daily Operations unit. OMCA Daily Operations manages a suite of Medicaid Management Information Systems (MMIS) that are utilized by clients and providers to submit claims, encounters, prior authorizations, enroll in Medicaid, view Client health information, and verify client eligibility.
The BA III reports to the Daily Operations manager and serves as a Product Owner (PO) for the Daily Operations program. Activities for this position include working with agile/scrum teams of contracted software vendors to implement system changes; performing analysis of systems and business processes to ensure alignment with business operations; overseeing and coordinating development of business requirements; performing project management tasks; leading and/or participating in external stakeholder discussions to provide and track feedback on upcoming system requirements.
This position will assist with ensuring the Medicaid Managed Information Systems (MMIS) meet agency and HHS stakeholder directives, plans, goals, and contract requirements for Medicaid/CHIP programs including, but not limited to Acute Care.
Works under minimal direction with considerable latitude for the use of initiative and independent judgment.
Essential Job Functions:
(30%) Serves as Product Owner for multiple competing projects. Analyze and review new project request documentation.
(20%) Serve as a liaison between the OMCA Daily Operations area, other Medicaid/CHIP areas, and external stakeholders such as the Claims and the Business Operations and Integration (BusOps) and the Application Maintenance and Development (AMD) vendors by assisting with gathering, developing, and documenting user requirements for the automation of new or improved existing systems to enhance business operations.
(15%) Leads and/or participates in workgroups to prepare, define, and develop procedures or processes to comply with established policies. Identifies gaps in established processes and collaborates with agency staff to make recommendations for their closure. Provides recommendations on improving process workflows in the operation of the Texas Medicaid Managed Information System (MMIS).
(10%) Participates in workgroups and public meetings regarding acute care program and policy issues, initiatives, and Medicaid program changes, and participates in special investigations, studies, and program analysis projects.
(10%) Compares project schedule with current progress. Identifies risks and issues and reports any change or impact on the project. Provides status updates on projects and responds to questions from management. Communicates timely with the supervisor regarding challenging problems and provides recommendations to ensure appropriate action is taken.
(5%) Oversees, monitors, and evaluates vendor contract requirements. Ensures compliance and determines whether contractors deliver services in accordance with the contract terms and requirements. Monitors requirements regularly in accordance with internal specifications and required review frequency.
(5%) Creates and maintains Policy and Procedure documents based on established processes.
(5%) Other duties as assigned.
(30%) Serves as Product Owner for multiple competing projects. Analyze and review new project request documentation.
(20%) Serve as a liaison between the OMCA Daily Operations area, other Medicaid/CHIP areas, and external stakeholders such as the Claims and the Business Operations and Integration (BusOps) and the Application Maintenance and Development (AMD) vendors by assisting with gathering, developing, and documenting user requirements for the automation of new or improved existing systems to enhance business operations.
(15%) Leads and/or participates in workgroups to prepare, define, and develop procedures or processes to comply with established policies. Identifies gaps in established processes and collaborates with agency staff to make recommendations for their closure. Provides recommendations on improving process workflows in the operation of the Texas Medicaid Managed Information System (MMIS).
(10%) Participates in workgroups and public meetings regarding acute care program and policy issues, initiatives, and Medicaid program changes, and participates in special investigations, studies, and program analysis projects.
(10%) Compares project schedule with current progress. Identifies risks and issues and reports any change or impact on the project. Provides status updates on projects and responds to questions from management. Communicates timely with the supervisor regarding challenging problems and provides recommendations to ensure appropriate action is taken.
(5%) Oversees, monitors, and evaluates vendor contract requirements. Ensures compliance and determines whether contractors deliver services in accordance with the contract terms and requirements. Monitors requirements regularly in accordance with internal specifications and required review frequency.
(5%) Creates and maintains Policy and Procedure documents based on established processes.
(5%) Other duties as assigned.
Knowledge Skills Abilities:
Knowledge:
Knowledge of claims processing systems or other healthcare IT systems preferred.
Knowledge of standard business analysis concepts and practices.
Knowledge of the agile software development life cycle.
Skills:
Skill in analyzing and evaluating complex program and policy issues.
Skill in assisting with developing and documenting business requirements.
Skill in analyzing and evaluating highly complicated information and presenting to stakeholders.
Skill in facilitating meetings.
Skill in eliciting business needs from subject matter experts.
Abilities:
Ability to identify and analyze system issues and determine business impacts.
Ability to analyze systems and procedures.
Ability to communicate effectively.
Ability to analyze and interpret state and federal laws, regulations, and policies.
Ability to evaluate systems for compliance with business and technical requirements.
Knowledge:
Knowledge of claims processing systems or other healthcare IT systems preferred.
Knowledge of standard business analysis concepts and practices.
Knowledge of the agile software development life cycle.
Skills:
Skill in analyzing and evaluating complex program and policy issues.
Skill in assisting with developing and documenting business requirements.
Skill in analyzing and evaluating highly complicated information and presenting to stakeholders.
Skill in facilitating meetings.
Skill in eliciting business needs from subject matter experts.
Abilities:
Ability to identify and analyze system issues and determine business impacts.
Ability to analyze systems and procedures.
Ability to communicate effectively.
Ability to analyze and interpret state and federal laws, regulations, and policies.
Ability to evaluate systems for compliance with business and technical requirements.
Registration or Licensure Requirements:
Certified Scrum Product Owner preferred.
Certified Scrum Product Owner preferred.
Initial Selection Criteria:
Graduation from an accredited four-year college or university with major course work in information technology, business administration, or a related field. Experience and education may be substituted on a year for year basis.
Experience in developing business or technical requirements for automated systems.
Experience facilitating review of business or technical requirements with stakeholders.
Experience with product ownership.
Experience working with an Agile (Scrum or similar) team.
Experience with state or federal government healthcare programs or policy preferred.
Experience working with healthcare systems preferred.
Graduation from an accredited four-year college or university with major course work in information technology, business administration, or a related field. Experience and education may be substituted on a year for year basis.
Experience in developing business or technical requirements for automated systems.
Experience facilitating review of business or technical requirements with stakeholders.
Experience with product ownership.
Experience working with an Agile (Scrum or similar) team.
Experience with state or federal government healthcare programs or policy preferred.
Experience working with healthcare systems preferred.
Additional Information:
1. Your application must be complete and contain all the requested information. Job histories must demonstrate how you meet the initial selection criteria at a minimum.
2. Any employment offer is contingent upon available budgeted funds. The offered salary will be determined in accordance with budgetary limits and the requirements of HHSC Human Resources Manual.
3. This position is eligible for telework in accordance with the HHSC Telework Policies, which includes in-office attendance.
4. Interviews may be conducted online via Microsoft Teams. Applicants should have ability to meet using virtual meeting tools.
1. Your application must be complete and contain all the requested information. Job histories must demonstrate how you meet the initial selection criteria at a minimum.
2. Any employment offer is contingent upon available budgeted funds. The offered salary will be determined in accordance with budgetary limits and the requirements of HHSC Human Resources Manual.
3. This position is eligible for telework in accordance with the HHSC Telework Policies, which includes in-office attendance.
4. Interviews may be conducted online via Microsoft Teams. Applicants should have ability to meet using virtual meeting tools.
MOS Code:
There may be no direct military occupation(s) that relate to the responsibilities, and registration or licensure requirements for this position. All active duty, reservists, guards, and veterans are encouraged to apply if they meet the qualifications for this position. For more information see the Texas State Auditor’s Military Crosswalk at http://www.hr.sao.state.tx.us/Compensation/JobDescriptions.aspx.
There may be no direct military occupation(s) that relate to the responsibilities, and registration or licensure requirements for this position. All active duty, reservists, guards, and veterans are encouraged to apply if they meet the qualifications for this position. For more information see the Texas State Auditor’s Military Crosswalk at http://www.hr.sao.state.tx.us/Compensation/JobDescriptions.aspx.
HHS agencies use E-Verify. You must bring your I-9 documentation with you on your first day of work.
In compliance with the Americans with Disabilities Act (ADA), HHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.
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