Business Analyst IV (Senior LTC Claims Product Owner)

TX-HHSC-DSHS-DFPS•Austin, TX

4d•$84,182 - $113,278•Hybrid

About The Position

The Medicaid and CHIP Services (MCS) department seeks a qualified technical candidate to fill the position of Business Analyst (BA) IV for the Long-Term Care Products (LTCP) unit. This position reports to the LTC Production Support Manager within the LTC Products and Business Automation Support (BAS) team. This position leads work on complex service authorization, claims adjudication, and claims payment initiatives and escalations. The IT Business Analyst IV provides leadership on projects that may cross multiple program areas, teams, and vendors. The position oversees the work efforts of other resources performing business analysis tasks such as research, user acceptance testing, reference data entry, operational tasks, and implementation coordination. The IT BA IV performs liaison activities bringing IT, Program, and Operational areas together to facilitate translation of business needs into system requirements or to coordinate communication and resolution of production issues. This position performs senior-level Product Owner responsibilities in an Agile development environment. The resource acts as a subject matter expert on LTC systems and team processes identifying opportunities for improvement and approving updates.

Requirements

Knowledge of Texas Medicaid claims management payment systems.
Knowledge of Information technology for business applications.
Knowledge of Agile Methodology.
Skill in coordinating and solving complex problems.
Skill in analyzing data needs, issues, and gaps impacting LTC service authorization and claim payment.
Skill in eliciting information needed to create user stories and groom the product backlog.
Ability to plan, assign, and oversee the work of others.
Ability to work collaboratively across MCS to accomplish objectives.
Ability to communicate effectively, both orally and in writing, with clients/customers to gather requirements and/orexplain technical information.
Graduation from an accredited four-year college or university with major course work in a related field is generally preferred.
Experience working with HHSC Medicaid Long-Term Care programs.
Experience working as a Product Owner in an Agile Development environment.
Experience in user acceptance testing.
Experience working with Texas Medicaid & Healthcare Partnership (TMHP).
Experience working with payment processing systems and their supporting systems.
Applicants should have the ability to meet using virtual meeting tools.
Selected candidates must be able to work onsite in the Austin office as needed.

Responsibilities

Oversees and provides consult/feedback/approvals to other business analysts performing the daily operational business activities of monitoring LTC systems, triaging and troubleshooting claim and payment escalations received by the LTC mailbox and supporting Program/Operational activities required to pay providers accurately or respond to audits.
Communicates effectively to LTC BAS team, program staff, HHSC leadership, and other stakeholders for the business needs and issues; and provides technical claims support assistance.
Defines and enforces standards, policies, and procedures used by the team.
Mentors and coaches junior team resources.
Oversees LTC BAS projects and leads business analysts on various initiatives.
Coordinates with state program areas, IT, and vendors to determine priorities of project tasks, activities required to complete tasks, resource allocation for tasks, and impact on end users.
Anticipates and escalates risks and issues.
Plans, scopes, develops benchmarks/timelines, consolidates business user requirements, and manages communications across BAS and HHSC Programs.
Coordinates development of project work plans and supports all aspects of projects and/or assigned tasks according to scope, budget, and schedules.
Oversees the development and prioritization of user stories.
Ensures that implemented features meet the business need.
Manages the product backlog.
Oversees business analysis and research across multiple systems impacting LTC claims payments.
Performs senior-level research and analysis within LTC systems to identify, troubleshoot, and oversee resolution of issues that impact provider claims payments and service authorizations.
Verifies and approves proposed business requirements, scope, timelines, business plans, or enhancements for LTC systems.
Coordinates and approves user acceptance testing within LTC systems for LTC BAS prior to completion and implementation of projects impacting LTC provider claims payments and service authorizations.
Oversee 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.
Facilitates collaborative work across MCS to identify innovative and effective solutions for clients and staff.
Serves as a liaison between teams, vendors, BAS, program and policy areas, and HHSC IT.
Coordinates and facilitates the analysis and determination of business needs and requirements for enhancement projects and modifications to complex automated LTC systems and applications such as TMHP CMS, LTC Provider, SAS, and TMHP LTC Online Portal.
Coordinates with business analysts to meet with impacted business users to gather and document user needs and translates into business user requirements.
Reviews expected outcomes to ensure that desired system results are achieved.
Facilitates analysis meetings with business users to determine the business needs that can be translated into the business system requirements and works with business users to establish system modification priorities.