Mgr,Bus Consultant (IC)
Core
Business Consultant translating CMS regulatory requirements into functional specifications for Medicare/Medicaid member communications (letters, ID cards) and data configuration.
Role type
Senior Business Analyst / Business Consultant (IC)
Builds
NextGen platform capabilities for Plan Sponsor Services
Domain
Healthcare / Insurance / Medicare & Medicaid
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
SQL/PLSQL, requirements gathering, functional decomposition, impact analysis, workflow diagramming, data modeling, CMS regulatory compliance, stakeholder coordination
Preferred skills
Pharmacy eligibility/claim transactions, enterprise-wide initiative management, senior-level relationship management, annual CMS contract-year updates
Technologies
SQL Server, Oracle, PLSQL, HPMS
Responsibilities
Translate business needs to high-quality Business Requirements and Functional Specifications, perform data analytics using SQL/PLSQL, ensure end-to-end traceability of requirements, conduct impact analysis of configuration changes, estimate level of effort, document requirements and acceptance criteria, monitor development activities, assist in triaging issues, contribute to test planning, develop business workflow diagrams, assist in data model and interface design, document data quality issues, contribute to data conversion strategies, participate in system design sessions, complete project activities on time, adhere to Agile methodology, develop user documentation, conduct interviews and research, support Product Owner with Scrum tasks
Seniority
Senior, hands-on IC