Senior Business Analyst with Medicaid/MMIS SME -100% Remote

The Dignify Solutions, LLC

Houston, TX(remote)

JOB DETAILS
SKILLS
Agile Programming Methodologies, Analysis Skills, Bug Tracking/Defect Management, Business Analysis, Business Processes, Centers for Medicare and Medicaid Services (CMS), Claims Processing, Communication Skills, Documentation, Functional Requirements Document (FRD), HIPAA (Health Insurance Portability and Accountability Act), HL7 (Health Level 7), Healthcare, Maintain Compliance, Medicaid, Mentoring, Problem Solving Skills, Process Analysis, Process Development, Process Improvement, Production Support, Requirements Management, Scrum Project Management and Software Development, State Laws and Regulations
LOCATION
Houston, TX(remote)
POSTED
30+ days ago
  • 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
Requirements
  • 7–12 years of experience in Medicaid domain, with strong MMIS experience
  • Deep understanding of claims processing, eligibility, and provider management systems
  • Proven experience in business analysis, stakeholder engagement, and documentation
  • Hands-on experience with Agile/Scrum methodologies
  • Strong analytical, communication, and problem-solving skills
Preferred Qualifications
  • Experience with MMIS platforms (Facets, QNXT, MES, etc.)
  • Knowledge of HL7/FHIR and healthcare data exchange standards
  • Experience working with state Medicaid agencies or healthcare payers

About the Company

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The Dignify Solutions, LLC