Fresher & Experienced IT Jobs: {SAP JOBS USA:134829} As Discussed : Rate Confirmation : Senior Business Analyst (8-10 Years / Healthcare Insurance) @ Columbia

Saturday, June 14, 2014

{SAP JOBS USA:134829} As Discussed : Rate Confirmation : Senior Business Analyst (8-10 Years / Healthcare Insurance) @ Columbia | SC // 12+ Months

Hi Anil,

Nice Speaking with you.

Please send me the rate confirmation for your consultant Rajesh Reddy as $55/hr on C2C all inclusive fo the position at SC.

Thanks and Regards

RICKY

Head/Sr.Resource Manager

APETAN CONSULTING LLC

72 Van Reipen Avenue # 255

Jersey City, NJ 07306

Direct: 201 377 5619
Email: RICKY@APETAN.COM

Fax: 201-526-6869

Gtalk: Ricky.Apetanconsulting@gmail.com

www.apetan.com

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From: Anil ABAL [mailto:anil@abaltech.com]
Sent: 13 June 2014 14:49
To: RICKY@APETAN.COM
Subject: Senior Business Analyst (8-10 Years / Healthcare Insurance) @ Columbia | SC // 12+ Months

Hi Ricky,

It was nice talk to you ,

As per our discussion over phone !

Please find the attached resume of my consultant Rajesh

Name: Rajesh Reddy

Ph: 618- 965 -8400

Email ID: rajeshkreddy45@gmail.com

Current Location: Charlotte, NC

Relocation: Open

Visa: H1B.

Thanks,

Anil

An "E-Verify Employer"

Hamilton, NJ 08619

Contact: 609-848-5390 * 206

Fax: 609-543-2609

Email: anil@abaltech.com

G-Talk:anilabal563

Linkedin : in.linkedin.com/pub/anil-kumar/73/619/396/

www.abaltech.com

Dear Candidate,

We have an urgent opening for Senior Business Analyst and I have sent you a job description ,Please go through it and let me know if you are comfortable with it and also send me your updated resume ASAP as applicable (Updated Resume with your Employer Details ) .

Title: Senior Business Analyst (8-10 Years / Healthcare Insurance)

Location: Columbia | SC

Start date: ASAP

Duration: 12+ Months

Job Description

This project will be very complex and will demand exceptionally high quality team members

DAILY DUTIES / RESPONSIBILITIES:
A Replacement MMIS Business Analyst (BA) is responsible for evaluating agency needs, as-is and to-be business processes, and technical designs to provide analysis and advice on strategies for information technology solutions and non-technical solutions.

Duties include:
• Requirements development execution, including the elicitation, analysis, specification and validation.
• Documenting and analyzing agency business processes and data. Recommending improvements, data requirements and relationships.
• Participate in the requirements management processes, including change control; version control; tracking and status reporting; and traceability.
• Providing requirement interpretation and guidance to technical and test teams.
• Proactively identifying risks, issues, and action items leading to possible solutions.
• Interacting with internal and external organizations (i.e. vendors, State and Federal government agencies, State providers and beneficiaries, and other stakeholders).
• Planning for, conducting, and reporting on testing and other quality assurance activities.
• Other related activities.

Subject matter areas include: provider management, member (beneficiary) management/eligibility, claims (professional, institutional, pharmacy, dental, durable medical equipment, transportation, etc.), third party liability, claims payment, and State budget assignments, financial management, provider reimbursement methodology, drug rebate, prior authorization, managed care, behavioral health, long-term care, program integrity, electronic health records, benefit plan administration, etc.

Familiarity with X12 EDI transactions, and the Affordable Care Act and it impacts on Medicaid eligibility and health insurance exchanges is also beneficial.

EXPERIENCE REQUIRED:

Claims Payment and Financial systems
• Medicaid budget assignments and financial general ledger reporting
• Strong background and at least six years experience in healthcare insurance business operations.
• At least four years experience in healthcare insurance IT software/systems implementations
• Ability to properly document business requirements.
• Ability to interpret business process and business data models.
• Vendor management experience –
• Superb written and oral communications skills, including the ability to give presentations to executive management. Strong proficiency in English is required.
• Impeccable integrity. This project will have very high visibility and will impact significant expenditures of public funds. Candidates must be confident with their abilities to make correct decisions and the courage to speak out when necessary.
• Willingness and ability to effectively engage with people and organizations on a continuous basis.
• Agile, waterfall, SDLC, PLC
• Requirements gathering experience

PREFERRED SKILLS (RANK IN ORDER OF IMPORTANCE):

• Medicaid Information Technology Architecture (MITA).
• Medicaid Enterprise Certification Toolkit (MECT).
• outsourced healthcare insurance operations environment.
• outsourced IT development project.
• creating business process and business data models.
• Public sector procurement experience is a plus.