Medicaid Business Analyst
Indexed description
Job Summary
The Business Analyst is responsible for the end-to-end integrity of Account Transfer (AT) XML data exchanges between the State Exchange and the Medicaid Management Information System (MMIS). You will perform gap analysis on XML schemas, define field-level mapping, and coordinate directly with Medicaid partners to ensure seamless data flow in production.
Key Responsibilities
- XML Data & Gap Analysis:
- Review and analyze Account Transfer XML files to identify data discrepancies, structural gaps, or missing fields between the Exchange and Medicaid systems.
- Troubleshoot and resolve production data issues related to failed or "stuck" account transfers.
- Field-Level Mapping & Documentation:
- Lead the coordination with Medicaid stakeholders to define and maintain Source-to-Target Mapping (STTM) documents for all shared data elements.
- Maintain a centralized repository of agreed-upon mapping logic, data dictionaries, and transformation rules.
- Medicaid Liaison & Traffic Monitoring:
- Act as the primary point of contact for Medicaid agencies, conducting regular "pulse checks" to monitor system-to-system traffic health.
- Report on transmission success rates and proactively identify trends in data rejection or service interruptions.
- Integration Testing & Validation:
- Support System Integration Testing (SIT) and User Acceptance Testing (UAT) by developing test cases specifically for data mapping and XML validation.
- Verify that incoming data correctly triggers the intended enrollment actions in the target system.
- Technical Skills: Proficiency in reading and validating XML/XSD; strong SQL skills for data reconciliation; experience with EDI or health data standards (HL7/NIEM).
- Experience: 3-5+ years in Medicaid, Healthcare IT, or Insurance Exchange environments with a focus on data integration.
- Analytical Ability: Proven experience in Gap Analysis and complex data mapping.
- Communication: Strong ability to translate technical XML issues into business impacts for Medicaid stakeholders and vice versa
- Competitive compensation - All In range of ($140,000-$170,000). (Please note that salary and compensation may vary based on factors such as skills, experience, performance and location.)
- We offer a comprehensive benefits package, including but not limited to:
- Health, Dental, Life, Disability, and Vision insurance
- Healthcare spending or reimbursement accounts (HSA/FSA)
- Retirement benefits (401k)
- Paid time off
- Holidays: 13 paid days per year
- Education assistance or tuition reimbursement-
- Employee discounts for Gym memberships & commuting/travel assistance
- We believe that working hard, when it is imbued with purpose, can and should be fun.
- You’ll find we are a “can do” place where people work together and roll up their sleeves to get the job done.
- Everyone has a voice; everyone’s ideas count, and everyone is respected.
- We have built a company, as well as a community of friends and colleagues, with respect for each other.
- This role may involve access to sensitive or regulated information. The candidate is expected to handle all data in accordance with company security, privacy, and data protection policies.
- Compliance with access control, data classification, and applicable legal and regulatory requirements is required.
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