UnitedHealth Group Senior CMS - Business Analyst Consultant - East Coast ( Travel 50% ) in Pittsburgh, Pennsylvania

Primary Responsibilities:

  • Guide and assist the state with preparation for CMS MMIS Certification Reviews

  • Coordinate Certification Review activities

  • In-depth analysis of system functions and operational procedures for compliance with CMS Certification requirements

  • Review Vendor/ Fiscal Agent deliverables

  • Coordinate with the State SME’s to draft “as-is” and “to-be” business process models and other artifacts

  • Participate in various aspects of the Medicaid Enterprise lifecycle process

  • Meet with internal department program staff, systems developers, and management

  • Contact with external entities including vendors, consultants, and others will also occur

  • Participate in project deliverable reviews and checklist walkthroughs

  • Update and maintenance of MS project schedule

  • Understanding of MITA 3.0 Framework

  • Work is performed under the supervision of the Certification Lead

  • The selected candidate is expected to be onsite full time for the duration of the engagement

Required Qualifications

  • Bachelor’s degree or equivalent experience

  • Minimum 4 years of MMIS Technical Analyst experience

  • Experience with CMS MMIS Certification process

  • Will be required to travel up to 50% to Charleston, WV

Preferred Qualifications

  • Medicaid business analysis experience

  • Excellent communication, problem-solving and customer service skills

  • Strong knowledge and experience with Medicaid Enterprise Certification Life Cycle (MECL)

  • Knowledge of organizational concepts and principles

  • Working knowledge of computers and capabilities of data processing equipment

  • Ability to interpret business requirements and translate those requirements into functional requirements for programming personnel

  • Ability to communicate effectively orally and in writing, including making presentations to groups of people

  • Ability to establish and maintain effective working relationships

  • Knowledge of the methods of SDLC, Agile, Waterfall

  • Ability to Author and/or review technical documents from beginning to finished deliverables

  • Ability to perform technical systems analysis functions

  • Demonstrate understanding of test case development, use case development and technical architectural principles especially as they relate to software development

  • Knowledge of MMIS Operations

  • Project Management experience

  • Master’s degree (Technology or Engineering preferred)

  • Understanding of the Health Care insurance payer lifecycle and business

  • Knowledge of and/or experience with Vermont’s healthcare programs

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work. SM

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.