Supports business, policy, and technical execution across MMIS and/or the Medicaid Pharmacy environment.
Acts as the primary Domain SME and trusted advisor on business processes and regulatory impacts.
Ensures compliance alignment and validates solution design.
Lead and participate in requirements and design sessions with clients and teams.
Develop and maintain domain design documentation and ensure accuracy of requirements.

Bachelor’s degree in Computer Science, Information Systems, Health Informatics, or a related field.
5 to 8 years of hands-on experience supporting healthcare system implementations, including MMIS solutions and Medicaid Pharmacy platforms.
Experience with QNXT or similar healthcare claims/encounter management systems.
Strong knowledge of state and federal Medicaid policy, regulations, and program rules (required).
Strong understanding of Medicaid domains, including claims, member, provider, and prior authorization processes.
Demonstrated experience translating policy and program rules into system requirements, configuration support, and design artifacts.
Strong knowledge of SQL is required, particularly for data analysis and validation.
Strong client communication skills, with experience interacting directly with business stakeholders.
Proven ability to lead or support functional demonstrations, walkthroughs, and collaborative working sessions.
Strong documentation, facilitation, and analytical skills.
Experience working in SDLC and Agile delivery environments.

Business Analyst – MMIS, Pharmacy

Key skills