Healthcare Systems Analyst

Location
Columbia, SC (Hybrid - 4 days onsite, 1 day remote. Candidates must reside in South Carolina; no relocation is permitted.)

Experience Level
Senior Level (7 or more years of experience)

Role Overview
The Business Analyst Consultant supports a multi-year enterprise systems modernization program to replace a state healthcare agency's legacy Medicaid Management Information System (MMIS) and related core applications. Operating within a modular, incremental modernization framework, this role serves as a key liaison between the business community and the IT organization. The consultant collaborates closely with Program Managers, Lead Project Managers, and cross-functional teams to design technical solutions, evaluate business processes, and align implementations with both state and federal requirements. This is a 12-month hybrid contract opportunity with a possibility of extension, requiring mandatory state-level criminal, credit, and E-Verify background screenings.

Key Responsibilities

Business Process Analysis & System Integration

• Perform detailed business process analysis, operational reviews, and system performance assessments across assigned work streams.
• Lead structured business design sessions to evaluate operations, identify process bottlenecks, and determine opportunities to automate functional workflows.
• Translate high-level business goals and requirements into detailed functional specifications, managing technical changes to those specifications.
• Support complex data configuration within core platform modules to ensure scalability, flexibility, and alignment with enterprise modernization goals.

Cross-Functional Collaboration & Liaison Operations

• Act as the primary liaison between business verticals and the IT organization to successfully align user needs with technical capabilities.
• Lead cross-functional meetings to produce integrated business designs that harmonize system functionality across various application modules.
• Coordinate priority queues, resource allocations, and operational dependencies across multiple concurrently running technical projects.
• Facilitate structured conflict resolution and collaborative sessions to resolve project bottlenecks, risks, and issue blocks.

Training, Mentorship, & Strategic Advisory

• Train, mentor, and guide project team members in delivering high-quality business solutions that meet the overall organizational strategy.
• Educate IT stakeholders, systems developers, and engineering partners on the strategic direction and operational needs of the business.
• Research and analyze emerging technology trends, leveraging this knowledge to suggest innovative solutions that enhance the agency's operational capabilities.
• Create, monitor, and maintain key performance indicators (KPIs) to track and report on project progress toward integration milestones.

Required Qualifications

• 7 or more years of experience working in the commercial healthcare industry.
• 3 or more years of experience supporting state Medicaid payer system integration, delivery, and modernization programs.
• 3 or more years of familiarity with Medicaid Information Technology Architecture (MITA) business architecture principles.
• 6 or more years of familiarity with standard data structures, Electronic Data Interchange (EDI), healthcare file formats, and processing methodologies.
• 6 or more years of comprehensive knowledge of business processes, operational methods, administrative procedures, and modern technologies.
• 6 or more years of experience managing the inner workings and dependencies of complex, cross-functional projects.
• Bachelor's degree in a technical, business, or healthcare-related field (or 7 or more years of equivalent professional experience in systems analysis or system delivery).
• Ability to successfully pass mandatory state-level background screenings, including criminal, credit, and E-Verify checks, and sign an agency confidentiality agreement.

Preferred Qualifications

• 6 or more years of experience driving large-scale business and technology integration initiatives.
• 6 or more years of experience working with Federal Certification requirements and public sector systems validation processes.
• 6 or more years of professional project management experience in a highly structured, enterprise IT environment.

Core Skills & Attributes

• Exceptional written and verbal communication skills, with the ability to lead dynamic discussions and deliver technical presentations.
• High precision and exceptional attention to detail in document generation and system design.
• Strong interpersonal skills with a proven track record of building positive stakeholder relationships and proactively addressing specific client needs.
• Ability to work productively within a professional, diverse office environment alongside a large team of distributed stakeholders.