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Business Analyst

Business Analyst

RICEFW Technologies IncJefferson City, MO, United States
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Project Goal

The primary goal is to modernize Missouri's Medicaid Management Information System (MMIS) by replacing its aging, COBOL-based legacy platform with modular, commercial off-the-shelf solutions that enhance efficiency, compliance, and service delivery.

This includes implementing Pharmacy Benefit Administration (PBA), Prior Authorization (PA), and Provider Enrollment (PE) solutions while ensuring effective Organizational Change Management (OCM) to engage stakeholders, improve processes, automate workflows, maximize drug rebate revenues, and meet Centers for Medicare & Medicaid Services (CMS) requirements for continued federal funding.

Generic Responsibilities

1. Program & Project Management

  • Develop and maintain Project Management Plans, schedules, and deliverables for all modules (PBA, PA, Provider Enrollment).
  • Apply structured project management practices and governance standards throughout planning, design, implementation, and go-live.
  • Monitor risks, issues, dependencies, and resources to ensure timely and cost-effective delivery.
  • Support the Executive Steering Committee with regular status reporting, decision support, and project documentation.

2. Governance & Oversight

  • Support the Executive Steering Committee and MME PMO in :
  • Defining project standards and change-management processes.
  • Establishing reporting systems and communication protocols.
  • Ensuring alignment with CMS and State strategic objectives.
  • Provide representation to steering meetings and participate in decision-making as directed by the State.

    • 3. Stakeholder Engagement & Communication

  • Perform stakeholder analysis and maintain continuous communication with internal divisions, providers, vendors, and external partners.
  • Develop and execute communication plans for staff, providers, and the public to ensure transparency and readiness.
  • Facilitate collaboration between OA-ITSD, business units, and all MMIS system vendors.

    • 4. Organizational Change Management (OCM)

  • Conduct organizational readiness assessments, staff preparation, and change impact analysis.
  • Deliver training strategies, adoption plans, and support materials to ensure smooth transitions to new processes and systems.

    • 5. System Implementation & Integration

  • Oversee planning, design, testing, and go-live activities for each solution (PBA, PA, Provider Enrollment).
  • Coordinate technical integration between new modules and the existing MMIS or future modular components.
  • Ensure hosting, maintenance, and system support post-implementation.

    • 6. Operations & Support

  • Provide provider technical help desk services, call center operations, and support for claims, prior authorizations, and provider enrollment activities.
  • Offer staff augmentation when necessary for clinical, technical, or administrative tasks.

    • 7. Compliance & Quality Assurance

  • Ensure all solutions meet CMS requirements, state and federal regulations, and Medicaid program standards.
  • Support audit readiness, data integrity, and security compliance.
  • Maintain robust reporting for financials, drug rebates, provider enrollments, and prior authorizations.

    • Key Responsibilities

  • Gather, document, and track business requirements.
  • Assist with the development and review of system design.
  • Identify, track, and document action items.
  • Develop use cases and test cases.
  • Execute test cases and review test results.
  • Monitor and report on testing activities across all project phases.
  • Prepare and review system documentation.
  • Prepare and review training documentation.
  • Work across project implementations as the PBA and PA solutions are implemented.
  • Collaborate directly with State-employed and Project Management Services Contractor Project Managers as part of the MME-PMO.
  • Facilitate and document project meetings as needed;
  • Develop use and test cases;
  • Prepare, review, and / or monitor compliance of any or all project artifacts listed in Task 2 below with the defined project methodology;
  • Prepare, execute, monitor and report on testing activities / status in each testing phase;
  • Validate post implementation with requirements traceability matrix and assist with defect identification, tracking, and resolution;
  • Assist in the preparation of training materials;
  • Identify and monitor the completion of action items;Identify and communicate potential project risks and issues for MME PMO review; and Prepare and post updated documentati

    • Mandatory Skills :

  • 6+ years of experience working within a Medicaid program or a healthcare related field
  • 4+ years of experience in the design, development, and / or implementation of a Medicaid, healthcare, and / or data warehouse Application Lifecycle Management (ALM) system in the role of primary business analyst
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    Analyst • Jefferson City, MO, United States

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