What are the responsibilities and job description for the MMIS Business analyst position at Jobs via Dice?
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We are looking for a highly skilled MMIS Business analyst to join a fast-paced team focused on critical Medicaid policy and system improvements.
If you are a problem-solver who enjoys bridging the gap between healthcare policy and technical implementation, this role is for you.
Logistics & Details
You will serve as a Subject Matter Expert (SME), translating complex federal medical coding requirements (ICD-10, CPT/HCPCS) into functional business rules. You will collaborate with IT developers to ensure the Medicaid Management Information System (MMIS) reflects accurate policy changes for seamless claims adjudication.
Core Qualifications
We are looking for a highly skilled MMIS Business analyst to join a fast-paced team focused on critical Medicaid policy and system improvements.
If you are a problem-solver who enjoys bridging the gap between healthcare policy and technical implementation, this role is for you.
Logistics & Details
- Work Arrangement: Fully Remote.
- Location Requirement: Must be a South Carolina resident. (No relocation allowed).
- Interview Process: 1-round, Virtual/Online.
- Preferred Skills: Experience in policy remediation, medical claims processing systems, and Optum Encoder.
You will serve as a Subject Matter Expert (SME), translating complex federal medical coding requirements (ICD-10, CPT/HCPCS) into functional business rules. You will collaborate with IT developers to ensure the Medicaid Management Information System (MMIS) reflects accurate policy changes for seamless claims adjudication.
Core Qualifications
- Healthcare Expertise: 5 years in healthcare insurance (program integrity, appeals, or medical review).
- Coding Mastery: 5 years of Medical Coding experience specifically in a payer environment.
- Technical Collaboration: 5 years working directly with IT developers/programmers to translate requirements.
- Clinical Background: 3 years of clinical experience (demonstrating strong assessment/critical thinking skills).
- Coding Knowledge: Deep proficiency in ICD/CPT/HCPCS translation and methodologies.