Healthcare Business Analyst / Systems Analyst

Computer Task Group, Inc•UNAVAILABLE, UNAVAILABLE

23h•Remote

About The Position

CTG is seeking a Healthcare Business Analyst / Systems Analyst to support a client in a remote, 10-month role. The position focuses on healthcare business and systems analysis for claims processing, provider enrollment, eligibility, and Medicaid program operations. The analyst will assess CA-MMIS requirements and system impacts, document business needs, support healthcare code maintenance, and connect DHCS stakeholders with technical teams to facilitate solution development. The role includes eliciting, documenting, validating, and translating needs into high-level and detailed business requirements, business rules, user stories, and acceptance criteria. The analyst will also facilitate requirements sessions, assess policy and regulatory impacts, model current and future business processes, and identify gaps or ambiguities so that business objectives and technical solutions remain aligned. The expected base salary is $40.00 to $50.00 per hour. CTG states that salary offers depend on factors including relevant skills, training, experience, education, market factors, and, where applicable, licensure or certifications. A competitive benefits package is offered.

Requirements

Experience as a Healthcare Business Analyst or Systems Analyst supporting Medicaid, healthcare claims, or government healthcare programs.
Hands-on experience with CA-MMIS, including OIL analysis, mainframe tables/files, and policy updates.
Experience with HIPAA EDI X12 transactions (837 I/P, 835, 270, 271, 276, and 277).
Knowledge of CPT, ICD, and HCPCS code maintenance.
Proven ability to facilitate stakeholder requirements sessions and translate complex business and regulatory needs into actionable system requirements.
Strong healthcare business and systems analysis expertise, including Medicaid and claims administration.
Knowledge of HIPAA regulations, EDI X12 transactions, healthcare claims, provider enrollment, and eligibility processes.
Proficiency in requirements documentation, business process modeling, and effort estimation.
Experience with IBM Engineering Lifecycle Management (ELM) and ServiceNow.
Ability to analyze mainframe data structures, interpret regulatory and policy changes, and communicate requirements to technical teams.
Strong analytical, problem-solving, documentation, and stakeholder communication skills.
Excellent verbal and written English communication skills and the ability to interact professionally with a diverse group are required.

Nice To Haves

Bachelor's degree in Information Systems, Computer Science, Healthcare Administration, Business Administration, or a related field preferred. Equivalent relevant professional experience may be considered.

Responsibilities

Analyze healthcare business and system requirements related to claims processing, provider enrollment, eligibility, and Medicaid program operations.
Conduct CA-MMIS OIL analysis, requirements assessments, and effort estimations.
Elicit, document, validate, and translate business needs into High-Level Requirements (HLRs), Detailed Business Requirements (DBRs), business rules, user stories, and acceptance criteria using IBM ELM and ServiceNow.
Analyze HIPAA EDI X12 transactions, including 837 I/P, 835, 270, 271, 276, and 277.
Assess CA-MMIS mainframe tables, files, policy updates, and related system impacts.
Support CPT, ICD, and HCPCS code maintenance.
Serve as a liaison between DHCS and technical teams to clarify requirements and facilitate solution development.
Facilitate Joint Application Requirements (JAR) sessions, policy and regulatory impact analysis, and current-state/future-state business process modeling.
Identify and resolve requirements gaps and ambiguities to ensure alignment between business objectives and technical solutions.