Senior Business Analyst - Medicaid Provider Enrollment Modernization

Accountabilities:

• • Facilitate discovery and requirements sessions with Medicaid policy, provider enrollment, operations, technical, security, and vendor stakeholders.
  • Analyze current provider enrollment processes, workflows, business rules, system interfaces, forms, notices, and operational challenges to identify improvement opportunities.
  • Elicit, document, validate, maintain, and trace business, functional, nonfunctional, data, and integration requirements throughout the project lifecycle.
  • Translate business needs into detailed user stories, use cases, process flows, business rules, acceptance criteria, and requirements traceability documentation.
  • Define requirements for provider-facing portals that enable providers to initiate, save, submit, and track enrollment applications and supporting documentation.
  • Document portal page flows, navigation, user roles, data requirements, and workflows in collaboration with UI/UX and development teams.
  • Support requirements related to authentication, role-based access, accessibility, security, and integration with enterprise identity-management solutions.
  • Analyze and document workflow automation requirements covering provider screening, licensing validation, risk assignment, notifications, site visits, fraud indicators, provider status changes, and work-queue management.
  • Collaborate with OnBase, MMIS, portal, and integration teams to define data mappings, interface requirements, ingestion and validation rules, exception handling, and bidirectional data exchanges.
  • Analyze provider enrollment data involving National Provider Identifiers, taxonomy, licenses, affiliations, revalidation, ownership, individual and group relationships, and ordering, referring, and prescribing providers.
  • Identify opportunities to reduce manual processing, strengthen data quality, improve workflow visibility, and automate enrollment activities.
  • Coordinate with business and technical stakeholders to resolve requirement gaps, manage changes, clarify dependencies, and assess downstream impacts.
  • Review system designs and technical documentation to verify alignment with approved business requirements.
  • Participate in Agile delivery activities including sprint planning, backlog refinement, demonstrations, defect reviews, and stakeholder discussions.
  • Develop test scenarios and expected outcomes based on approved requirements, business rules, and acceptance criteria.
  • Support system integration testing, user acceptance testing, regression testing, defect triage, and validation of implemented functionality.
  • Maintain end-to-end traceability from initial business needs through design, development, testing, and implementation.
  • Prepare project artifacts including status updates, meeting notes, decision logs, risk and issue documentation, and other required deliverables.

  Requirements

  • 7+ years of experience as a Business Analyst supporting complex information technology, systems modernization, or enterprise transformation initiatives.
  • Strong experience eliciting, documenting, validating, and managing detailed business and functional requirements.
  • Proven ability to develop process flows, user stories, use cases, business rules, data requirements, acceptance criteria, and requirements traceability matrices.
  • Experience collaborating with business stakeholders, developers, architects, testers, operations teams, project leadership, and third-party vendors.
  • Experience analyzing system interfaces, data exchanges, workflow automation, integrations, and cross-system dependencies.
  • Background supporting software development, systems integration, testing, defect resolution, and implementation activities.
  • Strong facilitation, analytical, problem-solving, documentation, and written and verbal communication skills.
  • Ability to translate complex policy, operational, and business needs into clear, actionable requirements for technical teams.
  • Strong organizational skills with the ability to manage multiple workstreams, priorities, requirements, and stakeholders in a complex environment.
  • Experience working within Agile or hybrid Agile delivery methodologies.
  • Bachelor’s degree in business, information systems, healthcare administration, computer science, or a related discipline; equivalent relevant professional experience may be considered.
  • Experience with Medicaid, healthcare, or Health and Human Services programs is preferred.
  • Knowledge of Medicaid provider enrollment processes, including screening, revalidation, licensing, affiliations, sanctions, exclusions, ownership, and provider data management, is a strong plus.
  • Experience supporting an MMIS or another large-scale public-sector healthcare system is preferred.
  • Experience with OnBase workflows, document management, work queues, electronic forms, or comparable workflow automation platforms is advantageous.
  • Experience with provider-facing portals, online application systems, APIs, system interfaces, data ingestion, validation, and bidirectional integrations is preferred.
  • Familiarity with provider data and screening sources such as NPPES, LEIE, and SAM.gov is a plus.
  • Knowledge of National Provider Identifiers, provider taxonomy, ordering/referring/prescribing requirements, and provider affiliation structures is beneficial.
  • Familiarity with identity-management technologies such as Okta and SAML, as well as ADA and WCAG accessibility requirements, is preferred.
  • Experience supporting state government or federally funded modernization programs is advantageous.
  • Familiarity with Jira, Azure DevOps, Confluence, Visio, or comparable requirements and process-modeling tools is preferred.
  • Business analysis or Agile certifications such as CBAP, CCBA, PMI-PBA, Certified Scrum Product Owner, or equivalent are a plus.

  Benefits

  • Fully remote position within the United States.
  • Competitive compensation aligned with experience and qualifications.
  • Medical, dental, and vision insurance with employer premium assistance.
  • Additional insurance coverage, including life and disability benefits.
  • Paid time off.
  • 401(k) retirement savings plan.
  • Health Savings Account (HSA).
  • Training courses and opportunities for continuous professional development.
  • Corporate wellness program.
  • Exposure to complex Medicaid and public-sector healthcare modernization initiatives.
  • Opportunity to work with multidisciplinary teams across business, technology, operations, and government program environments.
  • Family-oriented culture with an emphasis on work-life balance.
  • Opportunities to expand technical and business expertise through diverse projects and client engagements.