Required Technical and Professional Expertise:
8+ years experience performing the role of a business analyst with sound understanding and knowledge in Medicare Managed Care domain.
4+ years experience facilitating subject matter experts, end-users, and other stakeholders to identify business requirements, recommend solutions.
4+ years experience monitoring implementations and ongoing operations, tracking scope changes, managing schedules, and staff in complex environment.
4+ years experience leading client calls and be considered a subject matter expert to clients, stakeholders and internal team.
Experience with healthcare claims processing in payer/provider settings.
Program knowledge of Encounter Data.
Working experience in developing process models, coordinating and creating requirement specifications.
Preferred Technical and Professional Experience:
12 years Healthcare experience, with prior CMS experience
Healthcare Risk Adjustment modeling and processing experience
Expertise and certification in Lean Six Sigma
Expertise and certification in Agile
Experience working in a CMMI Maturity Level 3 (or higher) environment
Experience with mainframe systems