Job Description

The South Carolina Department of Health & Human Services (SCDHHS) is the State Medicaid

Agency for South Carolina. This program is focused on the replacement of the State’s Medicaid

Management Information System (MMIS). The program is a major undertaking for SCDHHS and

requires major transformation of culture, processes and technology. This program also supports

the Department’s transition from primarily a fee-for-service payor of claims towards a program

and policy driver for health outcomes primarily through managed care programs. The project’s

strategy supports significant innovation in MMIS thinking and mindset and is aligned with MMIS

innovation at the national level as well.

WHY IS THIS POSITION OPEN (new role, increased work load, new dept, resignation, promotion)?

This is a new position needed to support for the MMIS Modernization efforts.

SCOPE OF THE PROJECT:

SCDHHS is undertaking a multi-year Medicaid Enterprise System (MES) Modernization effort to

replace the State’s aging MMIS and related applications with more modern capabilities along

with corresponding business operations services.

The MES Modernization effort will be incremental and modular in nature with a focus on

configurable and scalable integrations, which allow for more flexibility and reduces time and

cost necessary to respond to federal and state enhancements.

The Delivery of Automated Systems for Healthcare (DASH) Program is the project management

program that will be managing the MES Modernization.

POSITION TITLE: IT HEALTHCARE CONSULTANT - BUSINESS ANALYST - CONSULTANT

PUBLIC SECTOR/GOV’T

EXPERIENCE REQUIRED?

Yes, required.

PRE-EMPLOYMENT CHECKS (drug, credit, criminal, motor vehicle)?

Criminal, E-verify, Credit, DHHS Confidentiality

DAILY DUTIES / RESPONSIBILITIES:

The Business Analyst will serve as a liaison between the business community and the IT

organization to provide technical solutions to meet user needs. They will work with the Program

Manager and the Lead Project Managers and will support the Project Management team to

ensure the principles, business goals and values of the program are met. The Business Analyst

will:

• Possess expertise in the business unit(s) they support, as well as an understanding of the

IT organization's systems and capabilities

• Analyze business partner's operations to understand their strengths and weaknesses to

determine opportunities to automate processes and functions

• Assist in the business process redesign and documentation as needed for new

technology

• Translate high level business requirements into functional specifications for the IT

organization and manage changes to such specifications

• Educate the IT organization on the direction of the business

• Negotiate agreements and commitments by facilitating communication between

business unit(s) and IT from initial requirements to final implementation

• Possess an understanding of technological trends and use this knowledge to bring

solutions to business units supported to enhance the enterprise's competitive edge

General Duties and Responsibilities:

• Perform business process analysis and performance assessments for the assigned

projects

• Train and mentor team members in delivering high quality business solutions that meet

the overall strategy and vision

• Build positive relationships with clients and proactively address specific needs

• Lead business design sessions within assigned modules and work streams

• Advocate and lead business integration in support of the MES Modernization

• Drive, though dynamic discussion, efficient configuration of data within the core

modules of MES Modernization

• Provide liaison role between business and IT verticals

• Ensure project deliverables for each project connect to the operational principles

• Coordinate priorities and resources between multiple projects.

• Provide updates on status and issues for all assignments

• Participate in scheduled operational meetings and routine team leads meetings

• Lead cross-functional meetings and produce business designs that integrate

functionality across modules

• Facilitate sessions to effectively resolve issues if any

• Provide recommendations of appropriate resources if necessary to ensure assignments

are completed within given time and budget

• Create and maintain key performance indicators to indicate project progress toward

business integration goals

REQUIRED SKILLS (RANK IN ORDER OF IMPORTANCE):

• 7 years of experience in commercial

healthcare

• 6 years of experience eliciting, mining,

and documenting business

PREFERRED SKILLS (RANK IN ORDER OF

IMPORTANCE):

• Knowledge of CMS Federal

Certification requirements and

processes

rules/processes

• 3 years of experience in State Medicaid

payer system integration and delivery

• 3 years of experience with inner workings

of cross functional projects

• 3 years familiarity with Medicaid

Information Technology Architecture

(MITA) business architecture principles

• 3 years familiarity with standard data

structures, electronic data interchange,

processes and related file formats

• 3 years ability to effectively work and

communicate, in both oral and written,

with all levels of the Agency from

frontline workers to Executive Staff as

well as the Contractor(s)

• Ability to work in a professional office

environment with a diverse group of

teammates

• Must have exceptional attention to detail

• Project management

• MMIS experience (project or

operations)

REQUIRED EDUCATION/CERTIFICATIONS:

Bachelor’s degree in a technical, business,

healthcare, or related field. Years of experience

can substitute for formal education.

PREFERRED EDUCATION/CERTIFICATIONS:

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