Senior Business Analyst – Medicaid Pharmacy Claims / MMIS

About the role

We are seeking a Senior Business Analyst to support Medicaid pharmacy claims and MMIS initiatives. This role partners with business stakeholders, vendors, and technical teams to define requirements, improve processes, support testing, and deliver compliant, 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.

Requirements

• 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.

Qualifications

• 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

Flexible working arrangements, health and welfare benefits, retirement savings, employee discounts, career growth opportunities, paid training, and paid time off. The estimated salary range for this role is $70,956 - $92,150. Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law.