We Are: Accenture is a global professional services company with leading capabilities in digital, cloud and security. Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Interactive, Technology and Operations services—all powered by the world’s largest network of Advanced Technology and Intelligent Operations centers. Over 500,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. We embrace the power of change to create value and shared success for our clients, people, shareholders, partners and communities. Visit us at www.accenture.com . You Are: A healthcare technology business analyst that can leverage your deep understanding of both healthcare operations and technological advancements to drive transformative solutions. Have expertise in translating complex healthcare workflows into comprehensive technical requirements for software development. Someone that has a proven track record of implementing healthcare IT solutions to enhance patient care delivery. Has a strong focus on Federal and State compliance and regulatory requirements such as HIPAA, ensuring that technology solutions meet industry standards and safeguard patient data privacy. Collaborating closely with State and Operational healthcare professionals and IT teams, to facilitate the integration of innovative technologies to streamline processes and improve clinical outcomes. Have a passion for healthcare and technology fuels your commitment to delivering solutions that positively impact both patient care and organizational efficiency. The Work:
Maintain the Texas Medicaid Core Applications, including Acute Care Claims Processing, Cash Financial, and Eligibility systems, ensuring their smooth operation on a daily basis.
Respond promptly to production support issues and alerts, escalating complex problems to the application team lead while strictly adhering to TMHP incident management processes and procedures.
Address assigned service requests, client inquiries, and state escalation support requests efficiently.
Collaborate in testing efforts and coordinate release control activities, meticulously planning and reviewing test models for product tests and release controls, encompassing plans, data, and scripts.
Collaborate with the application team lead to identify and document opportunities for process and technology improvements, potentially involving the definition of business processes and the execution of business process re-engineering as required.
Analyze and design new Core Application business processes, defining detailed functional requirements and use cases.
Contribute to the development of requirements into test conditions and expected results for product, performance, and user acceptance testing, ensuring a seamless transition of requirements and use cases to system architects and developers.
Actively participate in user and state meetings as necessary.
Travel may be required for this role. The amount of travel will vary from 0 to 100% depending on business need and client requirements
What You Need:
Minimum of 8 years of extensive experience specializing in Texas Medicaid systems, with a particular emphasis on Compass21 and/or CMS.
Minimum of 8 years of expertise in researching and resolving issues pertaining to NSK/CAGen systems.
Minimum of 8 years adeptly gathering and meticulously documenting requirements.
Minimum of 8 years in testing complex claim requirements to ensure robust system functionality.
Minimum of 2 years in both Waterfall and Agile methodologies, with a comprehensive understanding of their respective processes.
Bonus Points If:
Proficiency with Provider Enrollment systems processes and data flow.
Proficiency with financial processes associated with claims payment, ensuring accuracy timeliness.
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