Subject Matter Expert

Job description

1. Role: Senior Business Analyst – Medicaid/MMIS SME (D04)

• Act as a Medicaid/MMIS SME across claims, eligibility, enrollment, and provider modules
• Lead requirements gathering, business process analysis, and documentation (BRDs, FRDs, user stories)
• Translate complex business needs into clear functional and technical requirements
• Collaborate with stakeholders, product owners, and development teams
• Ensure compliance with CMS guidelines, HIPAA, and state Medicaid regulations
• Support defect management, and production support
• Identify process improvements and support system modernization initiatives
• Mentor business analysts and contribute to Agile delivery

• 7–12 years of experience inMedicaid domain, with strongMMIS experience
• Deep understanding ofclaims processing, eligibility, and provider management systems
• Proven experience inbusiness analysis, stakeholder engagement, and documentation
• Hands-on experience withAgile/Scrum methodologies
• Strong analytical, communication, and problem-solving skills

• Experience with MMIS platforms (Facets, QNXT, MES, etc.)
• Knowledge ofHL7/FHIR and healthcare data exchange standards
• Experience working withstate Medicaid agencies or healthcare payers

• Qualifications: Graduate
• Range of Year Experience-Min Year: 8
• Range of Year Experience-Max Year: 10