[Remote] Senior Business Analyst – Medicaid Pharmacy Claims / MMIS
Note: The job is a remote job and is open to candidates in USA. Conduent State Healthcare, LLC delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments. They are seeking a Senior Business Analyst to support Medicaid pharmacy claims and MMIS initiatives, partnering with stakeholders to define requirements, improve processes, and deliver high-quality system solutions.
Responsibilities
- Lead requirements gathering, analysis, documentation, and validation for Medicaid pharmacy claims, MMIS processing, eligibility, prior authorization, and related workflows
- Facilitate discussions with business, vendor, and technical teams to define requirements, resolve issues, and align on scope and priorities
- Translate business, policy, and regulatory needs into clear requirements, user stories, process flows, business rules, and acceptance criteria
- Analyze current and future-state processes to identify gaps, risks, dependencies, and improvement opportunities
- Maintain key project artifacts such as traceability matrices, workflow documentation, interface mappings, and decision logs
- Partner with testing teams to develop test scenarios, support SIT and UAT, manage defects, and validate business outcomes
- Support implementation, change requests, issue resolution, and production support activities
- Mentor junior analysts and promote consistent analysis, documentation, and collaboration practices
Skills
- Bachelor's degree in Business, Information Systems, Healthcare Administration, Public Administration, or a related field; equivalent experience may be considered
- 5+ years of experience as a Business Analyst or Systems Analyst supporting complex healthcare or public-sector systems
- 3+ years of experience with Medicaid claims processing, MMIS/MES platforms, or Medicaid pharmacy operations
- Strong experience documenting business and functional requirements, process flows, user stories, use cases, and acceptance criteria
- Experience with requirements traceability, change control, and support across the project lifecycle
- Hands-on experience with test planning, test case development, SIT, UAT, defect management, and validation of business outcomes
- Experience working in Agile and/or hybrid SDLC environments with cross-functional teams
- Strong facilitation, communication, analytical, and documentation skills
- Proficiency with tools such as Azure DevOps, Jira, SharePoint, Microsoft Office, Visio, and SQL
- Experience with Medicaid pharmacy claims standards, including NCPDP D.0
- Knowledge of CMS guidance, state Medicaid policy, HIPAA, and healthcare data exchange requirements
- Experience supporting PBM, PBA, or other Medicaid pharmacy vendor solutions
- Professional certifications such as CBAP, PMI-PBA, or CSM
- Experience serving as a lead analyst or mentoring other analysts on complex implementations
Benefits
- Health and Welfare Benefits: Our health and welfare benefits can be tailored to fit you and your family's needs and start on the first day of employment.
- Retirement Savings: We will support you as you save for your future.
- Employee Discounts: We offer you access to a vast selection of global, national, and local discounts on merchandise, services, travel, and more.
- Career Growth Opportunities: We help you thrive, so together, we can grow. We provide opportunities to advance your career with a vast portfolio of businesses and a global footprint.
- Paid Training: Earn while you learn and continue to grow with access to award-winning learning platforms throughout your Conduent career.
- Paid time off: We provide attractive paid time off packages designed for you to enjoy your life away from work.
- Great Work Environment: We are proud of our award-winning culture and the recognition we’ve received for our diversity efforts.
- In addition to base pay, this position, based on business need, may be eligible for a bonus or incentive.
- In addition, Conduent provides a variety of benefits to employees including health insurance coverage, voluntary dental and vision programs, life and disability insurance, a retirement savings plan, paid holidays, and paid time off (PTO) or vacation and/or sick time.
Company Overview
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