Medicaid Business Analyst – Claims Processing & SDLC

Join Fortuna's team where your expertise as a Senior Business Analyst will help drive solutions that improve the health and well-being of vulnerable communities. You'll work alongside passionate professionals to deliver innovative IT solutions in the healthcare space, ensuring projects align with client objectives and compliance standards. This is an opportunity to combine your technical acumen with a meaningful mission.

WORKSITE:
Remote - U.S.

WORK SCHEDULE:
Monday through Friday, 8:00 AM to 5:00 PM Mountain Time

PAY RATE:
$ 42.00 -$45.00 per hour

WHAT WE OFFER:

• Medical, dental, and vision insurance options

• 401(k) retirement savings plan

• Paid time off and holiday pay (where applicable)

• Remote work flexibility

• Opportunities for professional development and long-term project engagements

WHAT YOU'LL DO:

• Coordinate business analyst team duties and activities on IT projects; mentor and support junior analysts.

• Facilitate meetings with clients to gather and document requirements and explore potential solutions.

• Create test scenarios and develop test plans to ensure client requirements are accurately incorporated into system design.

• Analyze testing results throughout the project lifecycle.

• Provide time estimates for project-related tasks.

• Document lessons learned and recommend process improvements.

• Act as the liaison between clients, project managers, and technical staff to define and communicate business requirements.

• Work with clients to develop business specifications at project initiation.

• Analyze, plan, design, document, or recommend business process improvements that support client technology goals.

• Approve and validate test results to verify requirements have been met.

• Use analytical or relational database tools such as Excel or SQL to quantify the anticipated impact of work.

WHAT YOU'LL BRING:

• 6+ years of experience as a Business Analyst in healthcare or health insurance.

• Strong background in Medicaid, including claims processing using Institutional and Physician claim forms.

• Knowledge of Prior Authorization, Member, Provider, Long-Term Care, and Inpatient/Outpatient concepts.

• Experience with project and change management tools such as ALM and iTrace/rTrace.

• Software Development Life Cycle (SDLC) experience with Waterfall methodology.

• Experience creating deliverables, user manuals, and training documentation.

• Hands-on experience implementing benefit plan configuration updates in Medicaid Management Information Systems (MMIS).

Fortuna operates as a staffing agency that sources, screens, and presents potential candidates for employment opportunities on behalf of our clients.

Founded in 2012 by practicing professionals with more than 50 combined years of experience, Fortuna is headquartered in McClellan, California, with offices in Los Angeles and New York, and satellite offices in the Philippines and Israel. Fortuna is an active member of multiple California service agreements, including CMAS, ITMSA (Tier 2), and CalPERS SpringFed Pool, as well as multiple municipal and corporate vendor pools.

Career Site: www.gofortuna.com