Business Analyst – Claims / Benefits (Medicaid MMIS)
Title: Business Analyst – Claims / Benefits (Medicaid MMIS)Job Summary:We are seeking an experienced Business Analyst with strong Medicaid/MMIS expertise to support adult long-term care provider enrollment systems and related healthcare operations for a State of Wisconsin project. The ideal candidate will have hands-on experience with Medicaid systems, data analysis, policy support, and cross-functional coordination in a complex healthcare environment.Key Responsibilities:Serve as the primary point of contact for assigned systems and operational projects.Support operational administration of the adult long-term care (LTC) provider enrollment system.Lead project lifecycle activities including requirements gathering, design reviews, UAT coordination, and production validation.Analyze and troubleshoot system issues, data inconsistencies, and operational defects.Work closely with vendors, stakeholders, and internal teams to resolve technical and business process issues.Perform data extraction and analysis using SAS, Tableau, Excel, and related tools.Analyze healthcare policies, Medicaid regulations, HIPAA compliance standards, and operational procedures.Develop reports, charts, dashboards, and presentation materials for leadership and stakeholders.Conduct trend analysis and provide recommendations for system and process improvements.Collaborate with public/private agencies and healthcare providers on system enhancement initiatives.Required Skills & Experience:3+ years of Business Analyst experience supporting Medicaid/MMIS or similar healthcare systems.Strong understanding of Medicaid MMIS systems and healthcare operations.Experience with SDLC, business requirements gathering, testing, and system implementation.Hands-on experience with:interChangeOnBaseEDW/DAR (SAS)CARESStrong data analysis and reporting experience using Excel, SAS, Tableau, or similar tools.Knowledge of HIPAA regulations and healthcare data standards.Experience analyzing large datasets and interpreting statistical results.Excellent communication, collaboration, documentation, and presentation skills.Ability to work independently in a matrixed environment.Experience in one or more areas:Provider ManagementEligibility & EnrollmentClaims & EncountersBenefit PlansPreferred Qualifications:Certified Business Analysis Professional (CBAP/CABP) preferred.Experience supporting Wisconsin state healthcare programs.Knowledge of Wisconsin Adult Long-Term Care Programs.Strong organizational and time management skills.