[Hiring] Healthcare Business Analyst / Systems Analyst @Computer Task Group

Role Description

CTG is seeking to fill a Healthcare Business Analyst / Systems Analyst position for our client.

• Analyze healthcare business and system requirements related to claims processing, provider enrollment, eligibility, and Medicaid program operations.
• Conduct CA-MMIS OIL analysis, requirements assessments, and effort estimations.
• Elicit, document, validate, and translate business needs into:
  • High-Level Requirements (HLRs)
  • Detailed Business Requirements (DBRs)
  • Business rules
  • User stories
  • Acceptance criteria using IBM ELM and ServiceNow.
• Analyze HIPAA EDI X12 transactions, including:
  • 837 I/P
  • 835
  • 270
  • 271
  • 276
  • 277
• Assess CA-MMIS mainframe tables, files, policy updates, and related system impacts.
• Support CPT, ICD, and HCPCS code maintenance.
• Serve as a liaison between DHCS and technical teams to clarify requirements and facilitate solution development.
• Facilitate Joint Application Requirements (JAR) sessions, policy and regulatory impact analysis, and current-state/future-state business process modeling.
• Identify and resolve requirements gaps and ambiguities to ensure alignment between business objectives and technical solutions.

Qualifications

• Strong healthcare business and systems analysis expertise, including Medicaid and claims administration.
• Knowledge of HIPAA regulations, EDI X12 transactions, healthcare claims, provider enrollment, and eligibility processes.
• Proficiency in requirements documentation, business process modeling, and effort estimation.
• Experience with IBM Engineering Lifecycle Management (ELM) and ServiceNow.
• Ability to analyze mainframe data structures, interpret regulatory and policy changes, and communicate requirements to technical teams.
• Strong analytical, problem-solving, documentation, and stakeholder communication skills.

Requirements

• Experience as a Healthcare Business Analyst or Systems Analyst supporting Medicaid, healthcare claims, or government healthcare programs.
• Hands-on experience with CA-MMIS, including OIL analysis, mainframe tables/files, and policy updates.
• Experience with HIPAA EDI X12 transactions (837 I/P, 835, 270, 271, 276, and 277).
• Knowledge of CPT, ICD, and HCPCS code maintenance.
• Proven ability to facilitate stakeholder requirements sessions and translate complex business and regulatory needs into actionable system requirements.

Benefits

• The expected base salary for this position ranges from $40.00 to $50.00/hour.
• Salary offers are based on a wide range of factors including relevant skills, training, experience, education, market factors, and where applicable, licensure or certifications obtained.
• A competitive benefit package is also offered.