Job Description

Title: IT Healthcare Consultant – Business Analyst – Consultant

Duration: 12 Months

Location: Columbia, SC – Hybrid (4 days onsite, 1 day remote)

The State is undertaking a Medicaid Management Information System (MMIS) Modernization Program , a major cultural, process, and technology transformation. This initiative supports the Department’s transition from a fee-for-service payor model to a program and policy driver for health outcomes through managed care programs.

The effort aligns with national-level MMIS innovation strategies and is managed under the Delivery of Automated Systems for Healthcare (DASH) Program . The modernization will be modular and incremental, focusing on scalable, configurable integrations that enhance flexibility, reduce costs, and accelerate response to state and federal enhancements.

The Business Analyst will act as a liaison between business stakeholders and IT teams, ensuring that business needs are translated into effective technical solutions. Responsibilities include:

• Partner with Program Manager, Lead Project Managers, and stakeholders to ensure program goals are met.

• Analyze business operations to identify opportunities for automation and process optimization.

• Lead business process redesign and documentation efforts for new technologies.

• Translate high-level business requirements into functional specifications and manage changes.

• Educate IT teams on business priorities and strategies.

• Facilitate communication between business units and IT from requirements gathering through implementation.

• Support integration across modules and advocate for business-driven configuration.

• Conduct business design sessions and lead cross-functional workshops.

• Create and track Key Performance Indicators (KPIs) to measure progress toward business integration goals.

• Mentor team members and ensure delivery of high-quality solutions.

• Build strong client relationships and proactively address needs.

• 7+ years of experience in commercial healthcare .

• 6+ years of experience eliciting, analyzing, and documenting business rules and processes .

• 3+ years of experience with State Medicaid payer system integration and delivery .

• 3+ years working on cross-functional IT/business projects .

• 3+ years familiarity with Medicaid Information Technology Architecture (MITA) business architecture principles.

• 3+ years experience with standard data structures, EDI processes, and related file formats .

• Strong communication skills (oral and written) with all organizational levels, from frontline staff to executives.

• Exceptional attention to detail and ability to thrive in diverse, professional environments.

• Knowledge of CMS Federal Certification requirements and processes.

• Project management experience.

• MMIS experience (project or operations).

• Bachelor’s degree in Business, Healthcare, IT, or related field.

• Equivalent years of professional experience may substitute for formal education.

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