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

Role Description

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

Location: Remote

Duration: 10 months

Duties:

• 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, and acceptance criteria using IBM ELM and ServiceNow.
• Analyze HIPAA EDI X12 transactions, including 837 I/P, 835, 270, 271, 276, and 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.

Education

• Bachelor's degree in Information Systems, Computer Science, Healthcare Administration, Business Administration, or a related field preferred.
• Equivalent relevant professional experience may be considered.
• Excellent verbal and written English communication skills and the ability to interact professionally with a diverse group are required.

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.
• In addition to salary, a competitive benefit package is also offered.

To Apply

To be considered, please apply directly to this requisition using the link provided. Kindly forward this to any other interested parties. Thank you!