Job Description

Job Description: Senior Business Analyst Job Title: Senior Business Analyst (Lead BA HHS/MMIS) Location: Remote Position Summary Perform business requirements analysis, workflow analysis, and work with users to write functional specifications. Critically evaluate information gathered from multiple sources, reconcile conflicts, decompose high-level information into specific details, abstract up from low-level information to general understanding, and distinguish between user requests from true business needs. Performs in-depth assessment and analysis to provide business process re-engineering and transformation services for highly complex business applications. The Lead Business Analyst (Healthcare/MMIS) will serve as the lead for comprehensive business processes and requirements discovery across our large-scale state Medicaid enterprise. Knowledge of State Medicaid systems is crucial to being successful in this role along with an ability to drive complex systems and business process exploration. The right candidate also can apply a sophisticated methodology that requires deep healthcare (payor) domain subject matter expertise with cutting-edge artificial intelligence systems. Operating within a dynamic public-sector environment, the candidate will direct the discovery of massive legacy systems. Using artificial intelligence and large language models (AI), the Lead BA will accelerate the decomposition of undocumented source code, translating complex technical ecosystems into functional requirements, explicit policy mappings, and clear visual workflows. The role also requires a high degree of adaptability, including the ability to take on responsibilities beyond the standard job description, adjust to shifting priorities in a dynamic environment, and collaborate effectively with diverse teams and stakeholders across all levels of seniority and technical expertise.

Key Responsibilities

Requirements & System Discovery: Work and help to lead the project team to drive comprehensive business process and requirements discovery using business subject matter expertise and advanced artificial intelligence toolsets. AI-Assisted Analysis: Leverage AI to perform system logic discovery, parsing and analyzing undocumented code, legacy schemas, and large-scale operational structures to isolate foundational business rules and technical architectures. Workflow Engineering & Modeling: Document end-to-end operational systems and workflows to help in the creation of business and technical documentation including design documents, requirements, and generate highly structured diagrams utilizing Business Process Model and Notation (BPMN) or Unified Modeling Language (UML) standards. Policy-to-System Mapping: Analyze federal, state, and local regulatory policies and seamlessly map policy definitions directly to downstream system logic and functional software components. Acknowledge and record any gaps in operational functionality with federal and state requirements. Stakeholder & SME Facilitation: Lead intensive collaborative discovery sessions with technical and business Subject Matter Experts (SMEs), establishing consensus and bridging knowledge gaps. Traceability Assurance: Establish, manage, and defend rigorous requirements engineering frameworks, ensuring flawless end-to-end traceability from baseline policy to code level. Required Skills & Qualifications Education: Bachelor’s degree in healthcare administration, Computer Science, Information Systems, Business Administration, or a related field from an accredited university. Domain Expertise: Minimum of 7 years of dedicated experience as a Business Analyst within a State Medicaid Agency or other commercial insurance payor. Artificial Intelligence: Demonstrated experience effectively using AI including prompt engineering, AI-assisted requirements discovery, and the ability to use AI responsibly without bias. Modeling Frameworks: Proven, advanced experience drafting structured "As-Is" and "To-Be" operational process diagrams using Business Process Model and Notation (BPMN).

Requirements

Engineering: Demonstrated mastery of requirements engineering processes, including change control management, structured use case generation, and matrix traceability. Regulatory Knowledge: Deep understanding of healthcare regulatory compliance structures, including HIPAA data privacy frameworks, federal reporting standards, and CMS certification guidelines. Preferred Skills Advanced AI Toolkit Experience: Hands-on experience executing code/system rule discovery using AI, specialized Large Language Models (LLMs), or alternative generative AI prompting strategies. Certifications such as GitHub Copilot (GH-300), AWS Certified Machine Learning Engineer, and Claude Certified Architect (CCA) Foundations Legacy Deconstruction Expertise: Prior experience working on legacy platform modernization migrations, specifically mapping rules sourced from Mainframe environments (COBOL, Telon, DB2, or IMS). Data Analysis: Develop advanced SQL scripts, stored procedures, and interface files to support data ingestion, extraction, and transformation processes across multiple systems. Agile Scaling Certifications: Active certification under a major scaling framework, such as a Certified SAFe Product Owner/Product Manager (POPM) or SAFe Agilist (SA) designation. Advanced Degree: Master’s degree in management information systems (MIS), Biomedical Informatics, or a related technical discipline. Additional Skills Adaptability: Flexibility to handle tasks beyond the standard job description and support shifting project priorities. Versatility: Comfortable working in an environment where responsibilities may change, and able to move between different types of work as needed. Collaboration: Proven ability to partner with diverse teams and individuals at varying levels of leadership and technical expertise. Thanks