Business Analyst – Claims / Benefits (Medicaid MMIS)

Glint Tech Solutions LLCMadison, WI

About The Position

We are seeking an experienced Business Analyst with strong Medicaid/MMIS expertise to support adult long-term care provider enrollment systems and related healthcare operations for a State of Wisconsin project. The ideal candidate will have hands-on experience with Medicaid systems, data analysis, policy support, and cross-functional coordination in a complex healthcare environment.

Requirements

  • 3+ years of Business Analyst experience supporting Medicaid/MMIS or similar healthcare systems.
  • Strong understanding of Medicaid MMIS systems and healthcare operations.
  • Experience with SDLC, business requirements gathering, testing, and system implementation.
  • Hands-on experience with: interchange, OnBase, EDW/DAR (SAS), CARES
  • Strong data analysis and reporting experience using Excel, SAS, Tableau, or similar tools.
  • Knowledge of HIPAA regulations and healthcare data standards.
  • Experience analyzing large datasets and interpreting statistical results.
  • Excellent communication, collaboration, documentation, and presentation skills.
  • Ability to work independently in a matrixed environment.
  • Experience in one or more areas: Provider Management, Eligibility & Enrollment, Claims & Encounters, Benefit Plans

Nice To Haves

  • Certified Business Analysis Professional (CBAP/CABP) preferred.
  • Experience supporting Wisconsin state healthcare programs.
  • Knowledge of Wisconsin Adult Long-Term Care Programs.
  • Strong organizational and time management skills.

Responsibilities

  • Serve as the primary point of contact for assigned systems and operational projects.
  • Support operational administration of the adult long-term care (LTC) provider enrollment system.
  • Lead project lifecycle activities including requirements gathering, design reviews, UAT coordination, and production validation.
  • Analyze and troubleshoot system issues, data inconsistencies, and operational defects.
  • Work closely with vendors, stakeholders, and internal teams to resolve technical and business process issues.
  • Perform data extraction and analysis using SAS, Tableau, Excel, and related tools.
  • Analyze healthcare policies, Medicaid regulations, HIPAA compliance standards, and operational procedures.
  • Develop reports, charts, dashboards, and presentation materials for leadership and stakeholders.
  • Conduct trend analysis and provide recommendations for system and process improvements.
  • Collaborate with public/private agencies and healthcare providers on system enhancement initiatives.
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