Senior Business Analyst (MMIS Finance)

Conduent•Gates, NY

2d•$85,470 - $111,000•Remote

About The Position

Lead business and functional requirements for the MMIS Financial Management module from requirements gathering through implementation and production validation. Translate Medicaid payment operations into clear requirements for business, technical, and testing teams.

Requirements

Business Analyst experience with Medicaid MMIS/MES, healthcare payer systems, claims payment, or comparable financial operations.
Knowledge of claims adjudication, provider payment, accounts payable and receivable, recoveries, adjustments, refunds, offsets, and reconciliation.
Working knowledge of 837P, 837I, and 837D transactions and strong knowledge of the 835, including CAS, PLB, and payment balancing.
Knowledge of Medicare crossover, coordination of benefits, and third-party liability or recovery processes that affect Medicaid payment.
Ability to use SQL and X12 validation tools to trace claims, payments, receivables, remittances, and downstream financial data.
Experience with requirements documentation, stakeholder facilitation, traceability, SIT, UAT, defect triage, and production validation.

Nice To Haves

Eight or more years of business analysis or healthcare systems experience, including MMIS financial management or Medicaid payment operations.
Experience with CMdS or another Medicaid enterprise or healthcare payer platform such as Gainwell, QNXT, HealthRules, or Facets.
Knowledge of CMS-64, FMAP, 1099 reporting, MITA Financial Management, X12 820, or NCPDP transactions.
Experience with Agile delivery and backlog tools such as Azure DevOps or Jira.

Responsibilities

Facilitate stakeholder workshops, document current-state financial processes, identify gaps, and define target-state business and system needs.
Develop business and functional requirements, user stories, acceptance criteria, process flows, decision tables, data mappings, interface requirements, and reconciliation rules.
Analyze the end-to-end financial lifecycle, including claims payment, preliminary and final payment cycles, warrants and EFT, remittance advice, receivables, recoveries, recoupments, refunds, offsets, voids, reissues, and reconciliation.
Trace claims and financial transactions across adjudication, payment, 835 or paper remittance, banking, general-ledger interfaces, and financial reporting.
Collaborate with finance, program, development, architecture, and QA teams to define screens, work queues, interfaces, batch cycles, and system behavior.
Maintain requirements traceability, manage backlog priorities and requirement changes, and resolve business and testing questions throughout delivery.
Support SIT, UAT, regression testing, defect triage, root-cause analysis, and production validation, ensuring payment cycles and financial postings reconcile.
Assess Medicaid policy, regulatory, and CMS reporting impacts and communicate financial concepts and system behavior to technical and nontechnical stakeholders.