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CTG

IT services integration and digital branding

Healthcare Business Analyst / Systems Analyst

Business AnalysisConfirmed live in the last 24 hours
Full-timeRemote in USA$40 - $50 /hrRemote

About the Job

Requirements

  • Strong healthcare business and systems analysis expertise, including Medicaid and claims administration.
  • Knowledge of HIPAA regulations, Electronic Data Interchange (EDI) X12 transactions, healthcare claims, provider enrollment, and eligibility processes.
  • Proficiency in requirements documentation, business process modeling, and effort estimation.
  • Experience with IBM Engineering Lifecycle Management (ELM) and ServiceNow.
  • Ability to analyze mainframe data structures, interpret regulatory and policy changes, and communicate requirements to technical teams.
  • Experience as a Healthcare Business Analyst or Systems Analyst supporting Medicaid, healthcare claims, or government healthcare programs.
  • Hands-on experience with California Medicaid Management Information System (CA-MMIS), including OIL analysis, mainframe tables and files, and policy updates.
  • Experience with HIPAA EDI X12 transactions (837 I/P, 835, 270, 271, 276, and 277).
  • Knowledge of Current Procedural Terminology (CPT), International Classification of Diseases (ICD), and Healthcare Common Procedure Coding System (HCPCS) code maintenance.
  • Ability to facilitate stakeholder requirements sessions and translate complex business and regulatory needs into actionable system requirements.
  • Bachelor's degree in Information Systems, Computer Science, Healthcare Administration, Business Administration, or a related field is preferred; equivalent relevant professional experience may be considered.
  • Excellent verbal and written English communication skills and the ability to interact professionally with a diverse group.

Responsibilities

  • Analyze healthcare business and system requirements related to claims processing, provider enrollment, eligibility, and Medicaid program operations.
  • Conduct CA-MMIS OIL analysis, requirements assessments, and effort estimations.
  • Elicit, document, validate, and translate business needs into High-Level Requirements (HLRs), Detailed Business Requirements (DBRs), business rules, user stories, and acceptance criteria using IBM ELM and ServiceNow.
  • Analyze HIPAA EDI X12 transactions, including 837 I/P, 835, 270, 271, 276, and 277.
  • Assess CA-MMIS mainframe tables, files, policy updates, and related system impacts.
  • Support CPT, ICD, and HCPCS code maintenance.
  • Serve as a liaison between the California Department of Health Care Services (DHCS) and technical teams to clarify requirements and facilitate solution development.
  • Facilitate Joint Application Requirements (JAR) sessions, policy and regulatory impact analysis, and current-state/future-state business process modeling.
  • Identify and resolve requirements gaps and ambiguities to ensure alignment between business objectives and technical solutions.

About the Company

CTG

IT services integration and digital branding

CTG Belgium is integrating with the Cegeka family to combine IT services and digital branding. The teams collaborate closely to align capabilities and deliver more value to clients, especially in digital channels and branding. They are phasing out the CTG Belgium channel and directing followers to Cegeka’s channels, signaling a unified brand presence. Their work centers on blending Cegeka’s and CTG’s expertise to provide coordinated IT services and digital solutions for customers. The main goal is a smooth brand transition and a stronger, shared offering powered by Cegeka and CTG together.

Company size
201-500
Company stage
IPO
Headquarters
Buffalo, NY
Founded
1966

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