What are the responsibilities and job description for the Technical Medicaid Business Analyst - 100% Remote position at Amicis Global Technologies?
Job Title: Technical Medicaid Business Analyst Job Location: 100% Remote Role
Job Duration: 6 months of contract with possible extension
Job Summary
Job Duration: 6 months of contract with possible extension
Job Summary
- The Technical Medicaid Business Analyst serves as a critical bridge between Medicaid business operations and technical delivery teams.
- This role translates federal and state Medicaid requirements, health plan business needs, and operational workflows into detailed functional requirements that support system configuration, data integration, reporting, and compliance.
- The analyst partners closely with business stakeholders, IT teams, vendors, and external partners to ensure Medicaid systems and solutions meet contractual, regulatory, and operational expectations.
- Medicaid Business & Regulatory Analysis.
- Analyze federal and state Medicaid regulations, contract requirements, and policy guidance and translate them into clear business and functional requirements.
- Support Medicaid program areas such as eligibility, enrollment, claims, encounters, care management, provider management, quality, and compliance.
- Interpret CMS, state agency, and contractual changes and assess operational and system impacts.
- Develop detailed functional and technical requirements, including use cases, process flows, data mappings, interface specifications, and system configuration needs.
- Collaborate with IT, data, and vendor teams to design and validate technical solutions that align with Medicaid business needs.
- Support system enhancements, defect resolution, and new implementations across core Medicaid platforms (e.g., claims, encounters, care management, data warehouse).
- Analyze data flows between Medicaid systems, vendors, and external entities (state agencies, CMS, providers).
- Support reporting, analytics, and regulatory submissions (e.g., encounter data, quality measures, financial reporting).
- Assist with data validation, reconciliation, and root-cause analysis for Medicaid data issues.
- Serve as a liaison between Medicaid business teams, IT, finance, compliance, and external vendors.
- Facilitate requirements workshops, design sessions, and stakeholder reviews.
- Clearly communicate complex technical concepts to non-technical stakeholders and business priorities to technical teams.
- Support system testing activities, including test planning, test case development, and user acceptance testing (UAT).
- Validate that solutions meet Medicaid business and regulatory requirements prior to deployment.
- Support go-live activities and post-implementation issue resolution.
- Maintain clear, audit-ready documentation of requirements, decisions, and approvals.
- Ensure alignment with Medicaid governance, SDLC, and change management processes.
- Support audits, regulatory reviews, and compliance inquiries as needed.
- Bachelor's degree in Business, Information Systems, Health Administration, Public Health, or a related field (or equivalent experience).
- 5 years of experience as a Business Analyst, with direct Medicaid or healthcare payer experience.
- Strong understanding of Medicaid programs, managed care operations, and state/federal compliance requirements.
- Experience translating business requirements into technical specifications.
- Experience working with IT teams, system vendors, and data/reporting teams.
- Strong analytical, documentation, and problem-solving skills.
- Experience supporting Medicaid managed care organizations (MCOs) or state Medicaid programs.
- Familiarity with Medicaid healthcare payer systems such as claims platforms, encounter processing, care management systems, or eligibility/enrollment platforms.
- Experience with data analysis, SQL, or data warehouse concepts.
- Knowledge of CMS reporting, state encounter submissions, or quality programs.
- Experience with Agile, SAFe, or traditional SDLC methodologies.
- Medicaid subject matter expertise.
- Technical and systems thinking.
- Requirements elicitation and documentation.
- Data analysis and validation.
- Stakeholder communication.
- Regulatory and compliance awareness.
- Attention to detail and audit readiness.