Key responsibilities: Delivery & analysis: Own requirements and functional design for CMdS modules (Claims, Member, Finance, and related interfaces). Define epics, user stories, and definition of done; prioritize against Medicaid policy, MES certification goals, and release plans. Facilitate working sessions; clarify requirements for developers and QA; resolve functional questions during build and test. Track scope, dependencies, risks, and decisions; maintain traceability from legacy rule to CMdS design to test evidence.
Key responsibilities: Delivery & analysis: Own requirements and functional design for CMdS modules (Claims, Member, Finance, and related interfaces). Define epics, user stories, and definition of done; prioritize against Medicaid policy, MES certification goals, and release plans. Facilitate working sessions; clarify requirements for developers and QA; resolve functional questions during build and test. Track scope, dependencies, risks, and decisions; maintain traceability from legacy rule to CMdS design to test evidence.
Functional design (Claims, Member, Finance): - Claims: Lead functional design for claim intake, claim type assignment, validity/pricing edits, adjustment/void, crossover, encounters, remittance, and related edit disposition behavior; map legacy rules to CMdS configuration and customizations. - Member: Lead design for eligibility spans, aid category / benefit package assignment, enrollment, MCO/FFS indicators, and interfaces from state eligibility systems into CMdS Member. - Finance: Lead d
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Based on: Business Analyst – CMdS MES/MMIS
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Functional design (Claims, Member, Finance): - Claims: Lead functional design for claim intake, claim type assignment, validity/pricing edits, adjustment/void, crossover, encounters, remittance, and related edit disposition behavior; map legacy rules to CMdS configuration and customizations. - Member: Lead design for eligibility spans, aid category / benefit package assignment, enrollment, MCO/FFS indicators, and interfaces from state eligibility systems into CMdS Member. - Finance: Lead d
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Based on: Business Analyst – CMdS MES/MMIS
Насколько эта вакансия подходит вашему резюме
Войдите, чтобы увидеть AI match score и персональную ленту.
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