Provider Enrollment Business Analyst

Location: Austin, TX

About the role

The Texas Health and Human Services Commission (HHSC) Medicaid & CHIP Services (MCS) department seeks a highly qualified Business Analyst III (BA III) in the Provider Enrollment (PE) unit. Healthcare providers who want to participate in Texas Medicaid must enroll in the program and periodically revalidate their enrollment. The PE unit oversees the policies, operations, and systems that support the provider enrollment process. This position will support PE systems including the Provider Enrollment Management System (PEMS).

The ideal candidate thrives in an environment that emphasizes teamwork to achieve goals, excellence through high professional standards and personal accountability, curiosity to continuously grow and learn, critical thinking for effective execution, and integrity to do things right even when what is right is not easy.

The BA III reports to the PE Manager and serves as a technical lead for the PE program.

Responsibilities

• Agile Management (30%) – Serves as the technical lead for PE technology projects. Works with agile/scrum teams of contracted software vendors to implement system enhancements, maintenance, and changes through the Scaled Agile Framework (SAFe Agile) software development methodology (or other methodologies). Develops, refines, and prioritizes epics, user stories, and product backlog items. Documents project work through reporting tools. Consults with subject matter experts to get input on technology changes. Monitors throughput of scrum team and sprint cycles to ensure performance targets are met.
• Business Analysis (25%) – Performs analysis of multiple interrelated systems and business processes to ensure alignment with business operations. Coordinates across the PE program and external stakeholders to develop system requirements and business processes that align with strategic goals and objectives. Recommends and oversees the development and integration of new operational or systematic methods and procedures to improve the program and resolve identified issues. Reviews system functionality against documented requirements to determine if the system is performing as expected. Assesses system defects for business impact and verifies that solutions comply with system and program requirements. Ensures severity levels of defects are assigned correctly. Ensures defects are tested before being promoted into production. Coordinates with HHSC contract management to ensure that defects are resolved timely per the contractual SLAs.
• Analysis and Requirement Development (20%) – Oversees and coordinates development of business requirements for Provider Enrollment. Analyzes PE systems data, claims processing systems, and other related systems to identify and make recommendations for business requirement updates or new projects. Develops, or assists with developing project intake requests and system change requests.
• Stakeholder Liaison & Communications (10%) – Represents the PE unit in stakeholder workgroups to elicit business requirements and present proposed solutions. Responds to inquiries. Prepares and approves written reports for department leadership. Ensures communication related to PE special projects.
• Complaints and Escalations (10%) – Assists staff with technical research to resolve complaints and provider escalations. Communicates directly with stakeholders to troubleshoot issues and provide resolution. Reviews PE policies and procedures, training deliverables, and other PE-related materials.
• Provider Enrollment Related Support (5%) – Assists the HHSC Agency with provider enrollment related complaints, escalations, and requests for information. Provides accurate, comprehensive, and timely responses to escalations and complaints.

Requirements

• Graduation from an accredited four-year college or university with major course work in information technology, business administration, or a related field. Experience and education may be substituted on a year-for-year basis.
• Experience in developing business or technical requirements for automated systems.
• Experience facilitating review of business or technical requirements with stakeholders.
• Experience with product ownership.
• Experience working with an Agile (Scrum or similar) team.
• Experience with state or federal government healthcare programs or policy preferred.
• Experience working with healthcare systems preferred.
• Experience working with third-party developers preferred.

Skills

• Knowledge of healthcare IT systems preferred.
• Knowledge of standard business analysis concepts and practices.
• Knowledge of the agile software development life cycle.
• Skill in analyzing and evaluating complex program and policy issues.
• Skill in developing and documenting business requirements.
• Skill in analyzing and evaluating highly complicated information and presenting to stakeholders.
• Skill in facilitating meetings.
• Skill in eliciting business needs from subject matter experts.
• Ability to identify and analyze system issues and determine business impacts.
• Ability to analyze systems and procedures.
• Ability to communicate effectively.
• Ability to analyze and interpret state and federal laws, regulations, and policies.
• Ability to train and lead teammates.
• Ability to evaluate systems for compliance with business and technical requirements.

Qualifications

• Certified Scrum Product Owner or Certified Scrum Master (CSM) preferred.

Benefits

Our comprehensive benefits package includes:

• 100% paid employee health insurance for full-time eligible employees.
• A defined benefit pension plan.
• Generous time off benefits.
• Numerous opportunities for career advancement.

Explore more details on the Benefits of Working at HHS webpage.

Pay

Salary Range: $5,797.66 - $7,652.91 per month

Schedule

• Full-time, regular position.
• Day shift.
• Eligible for telework, including in-office attendance three days a week (subject to change).
• Travel: Up to 5%.