Technical Business Analysis Engineer III (Medicaid)

Conduent•Albuquerque, NM

7d•Remote

About The Position

Conduent is seeking a Senior Medicaid Technical Business Analysis Engineer with a strong background in Medicaid operations, policy, and claims processing. This role is ideal for a problem solver who thrives at the intersection of business and technology, enjoys tackling complex operational challenges, and can translate regulatory and business requirements into effective system solutions. As a key member of our team, you will collaborate with business stakeholders, product teams, architects, developers, and QA professionals to support claims processing operations, investigate system and business issues, evaluate policy changes, and drive solutions that improve efficiency, compliance, and member outcomes.

Requirements

Experience interpreting and applying Medicaid policies, CMS regulations, and state healthcare program requirements.
Strong knowledge of Medicaid claims processing and payment systems.
Ability to understand and apply Medicaid payment methodologies in business analysis and testing activities.
Strong analytical, troubleshooting, and problem-solving skills.
Ability to independently research and evaluate documentation, policies, billing manuals, and technical specifications.
Excellent communication and collaboration skills with both business and technical stakeholders.
Professional presence with the ability to manage multiple priorities in a fast-paced environment.

Nice To Haves

8+ years of healthcare industry experience, preferably within the MMIS (Medicaid Management Information System) domain.
Proven experience supporting large-scale Medicaid systems and operational processes.
Working knowledge of SQL and relational database concepts.
Strong presentation, facilitation, and organizational skills.
Proficiency in Microsoft Office applications, including Outlook, Word, and Excel.
Excellent written and verbal communication skills with a strong customer-focused mindset.
Ability to work independently while driving initiatives from analysis through implementation.

Responsibilities

Partner with business stakeholders to gather, analyze, and document business and system requirements.
Investigate suspended claims, operational issues, and system defects to identify root causes and recommend solutions.
Collaborate with development and QA teams to design, test, and validate system enhancements and operational improvements.
Review Medicaid policy updates, CMS mandates, and client directives to assess impacts on business processes and system functionality.
Conduct research using billing manuals, design documentation, and regulatory guidance to support issue resolution and decision-making.
Document and improve business processes to increase operational efficiency and effectiveness.
Serve as a liaison between business and technical teams, ensuring clear communication and alignment throughout the project lifecycle.
Develop test strategies, test scenarios, and test plans that validate state policy requirements and payment methodologies.
Support User Acceptance Testing (UAT) activities and facilitate successful implementation of system changes.
Analyze data and trends to provide actionable insights and support operational reporting needs.