Systems Analyst Senior

Systems Analyst Senior Location: This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Systems Analyst Senior serves as a strategic business and systems partner responsible for supporting organizational initiatives that improve Medicaid encounter performance, regulatory compliance, data integrity, financial outcomes, and operational efficiency through business analysis, technology solutions, and cross-functional collaboration. The ideal candidate is a collaborative business systems professional with strong analytical and problem-solving skills and experience supporting complex healthcare operations and business systems. How you will make an impact: Support Medicaid Encounters systems, data, and operational initiatives that improve compliance with state contractual requirements, encounter accuracy, completeness, timeliness, financial reconciliation, and audit readiness.  Partner with IT, Reporting, Health Plans, Compliance, Actuarial, Finance, Provider, Vendor, and upstream operational teams to identify root causes, define business requirements, and implement scalable system and process improvements.  Define, document, and validate business requirements, system enhancements, testing strategies, and implementation plans supporting encounter submissions, pends, rejects, financial reconciliations, risk adjustment, rate setting, and cost-of-care initiatives.  Analyze encounter data across systems and markets to identify trends, operational risks, revenue leakage, compliance concerns, backlog drivers, and opportunities to improve first-pass acceptance and submission performance.  Support cross-functional remediation efforts for encounter processing issues including internal pends, external rejects, provider and member data quality, HIPAA compliance, technical defects, duplicate claims, vendor data, and state-specific processing requirements.  Partner with Reporting and IT to develop dashboards, operational reporting, analytics, and data governance capabilities that improve visibility, operational performance, and decision-making.  Support financial reconciliation initiatives by translating business and operational needs into requirements that improve completeness, category-of-service alignment, variance identification, and reconciliation performance.  Prepare leadership updates summarizing issues, root causes, risks, action plans, and implementation progress for governance meetings and operational reviews.  Manages integrated functionality, usability, reliability, performance and support requirements of a system. Creates feature test strategies and environment needs. Provides the link between the technical and business views of the system by ensuring that the technical solutions being developed will satisfy the needs of the business. Applies and mentors use of tools to define requirements.   Anticipates and identifies opportunities for improvement.   Ensures high level designs including architecture requirements are accurately documented and map to approved requirements. Assists in developing training documentation and proactive identification of additional documentation needs.

Requires an BA/BS degree in Information Technology, Computer Science or related field of study and a minimum of 3  years experience with documenting