Business Analyst III (LTC Production Support)

TX-HHSC-DSHS-DFPS•Austin, TX

5d•$5,798 - $9,508•Hybrid

About The Position

The Medicaid and CHIP Services (MCS) department seeks a qualified technical candidate to fill the position of Business Analyst (BA) III for the Long-Term Care Products (LTCP) unit. This position reports to the Manager of the Long-Term Care Production Support unit within the Operations Management Division. This position will be responsible for analysis, research, and resolution of Long-Term Care TIER 3 escalations received. This position will perform advanced technical work identifying, communicating, and directing resolution of long-term care system-related issues including those impacting service authorizations and timely, accurate provider payment.

Requirements

Experience working on payment processing systems and their supporting systems.
Experience working with Texas Medicaid programs and systems.
Experience in user acceptance testing.
Experience identifying, troubleshooting, and overseeing resolution of issues that impact systems or users.
Information technology frameworks for business applications.
Long-term care systems such as CMS and the LTC OP.
TMHP operational and technology organization.
User Acceptance Testing methodologies.
Effective communication, both orally and in writing, with business users to gather requirements and/or explain technical information.
Analyzing and organizing technical data.
Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions, or approaches to problems.
Exercise independent judgment, prioritize tasks, work under time constraints and show initiative.
Interpret and present research findings.
Coordinate with others to resolve complex technical problems.
Conduct/review user testing of automated systems.

Nice To Haves

Graduation from an accredited four-year college or university with major course work in a related field is generally preferred.
Five or more years’ experience in operations support for HHSC automated systems.
Experience with Home and Community-Based Services (HCS) and Texas Home Living (TxHmL) waiver programs.

Responsibilities

Coordinates with other analysts to perform the daily operational business activities of monitoring the long-term care (LTC) Medicaid Management Information Systems (MMIS), troubleshooting, and solving problems related to provider claims payments and service authorizations.
Researches and analyzes authorization and claims payment issues, identifies the root cause, and engages the necessary resources to resolve the issues.
Communicates business needs and issues with LTCP staff, program staff, and Texas Medicaid & Healthcare Partnership (TMHP).
Provides technical claims support assistance to Operations and HHSC program staff.
Performs advanced business analysis and research for LTCP.
Identifies and resolves data issues that impact provider claims payments and service authorizations within MMIS.
Research and analyze business requirements, intake documents, or initiatives for enhancements and modifications for MMIS (includes TMHP Claims Management System (CMS), Long-Term Care Provider, Service Authorization System (SAS), and TMHP LTC Online Portal) impacting LTC Business Automation Support (BAS).
Determines, develops, and documents business requirements, timelines, and scope for enhancements and modifications for projects that impact provider claims payments.
Coordinates and performs user acceptance testing within MMIS (TMHP CMS, LTC Provider, Service Authorization System (SAS), and TMHP LTC Online Portal) for BAS and TMHP prior to completion and implementation of projects impacting LTC provider claims payments and service authorizations.
Coordinates the development of business scenarios that test changes made to automated systems.
Monitors the incorporation of system changes into the applications to be tested in the test environment and the testing of those changes to ensure that business requirements have been met.
Monitors business end user testing and reviews feedback from users and results to ensure required system modifications meet business requirements.
Tracks progress and status of testing and communicates risks and issues to management.
Coordinates with HHSC program areas, HHSC IT and TMHP to determine priorities of project tasks, activities required to complete tasks, resource allocation for tasks, and critical impact on end users through risk analysis.
Plans project scope, develop benchmarks/timelines, consolidates business user requirements, and manages communications across BAS and HHSC program areas.
Manages and completes all aspects of projects and/or assigned tasks according to schedules and project work plans.
Serves as a liaison between BAS and program staff, HHSC IT, and TMHP.
Reviews the analysis, determination and documentation of business needs and system requirements for enhancements and modifications to complex automated MMIS systems and applications such as TMHP CMS, LTC Provider, SAS, and TMHP LTC Online Portal.