Senior Business Analyst – Medicaid Pharmacy Claims / MMIS at Conduent

Washington Township, New Jersey, United States -

Full Time

Start Date

Immediate

Expiry Date

10 Sep, 26

Salary

92150.0

Posted On

12 Jun, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Business Analysis, Medicaid Pharmacy Claims, MMIS, Requirements Gathering, User Stories, Process Mapping, SIT, UAT, Agile, SQL, Azure DevOps, Jira, Visio, NCPDP D.0, Defect Management, Stakeholder Management

Industry

Business Consulting and Services

Description

We are seeking a Senior Business Analyst to support Medicaid pharmacy claims and MMIS initiatives. This role partners with business stakeholders, vendors, and technical teams to define requirements, improve processes, support testing, and deliver compliant, high-quality system solutions. The ideal candidate has strong experience in Medicaid pharmacy operations, claims processing, eligibility, and business analysis across the project lifecycle. Key Responsibilities * Lead requirements gathering, analysis, documentation, and validation for Medicaid pharmacy claims, MMIS processing, eligibility, prior authorization, and related workflows. * Facilitate discussions with business, vendor, and technical teams to define requirements, resolve issues, and align on scope and priorities. * Translate business, policy, and regulatory needs into clear requirements, user stories, process flows, business rules, and acceptance criteria. * Analyze current and future-state processes to identify gaps, risks, dependencies, and improvement opportunities. * Maintain key project artifacts such as traceability matrices, workflow documentation, interface mappings, and decision logs. * Partner with testing teams to develop test scenarios, support SIT and UAT, manage defects, and validate business outcomes. * Support implementation, change requests, issue resolution, and production support activities. * Mentor junior analysts and promote consistent analysis, documentation, and collaboration practices. Required Qualifications * Bachelor’s degree in Business, Information Systems, Healthcare Administration, Public Administration, or a related field; equivalent experience may be considered. * 5+ years of experience as a Business Analyst or Systems Analyst supporting complex healthcare or public-sector systems. * 3+ years of experience with Medicaid claims processing, MMIS/MES platforms, or Medicaid pharmacy operations. * Strong experience documenting business and functional requirements, process flows, user stories, use cases, and acceptance criteria. * Experience with requirements traceability, change control, and support across the project lifecycle. * Hands-on experience with test planning, test case development, SIT, UAT, defect management, and validation of business outcomes. * Experience working in Agile and/or hybrid SDLC environments with cross-functional teams. * Strong facilitation, communication, analytical, and documentation skills. * Proficiency with tools such as Azure DevOps, Jira, SharePoint, Microsoft Office, Visio, and SQL. Preferred Qualifications * Experience with Medicaid pharmacy claims standards, including NCPDP D.0. * Knowledge of CMS guidance, state Medicaid policy, HIPAA, and healthcare data exchange requirements. * Experience supporting PBM, PBA, or other Medicaid pharmacy vendor solutions. * Professional certifications such as CBAP, PMI-PBA, or CSM. * Experience serving as a lead analyst or mentoring other analysts on complex implementations. Flexible Working At Conduent, we want you to be yourself. We recognize that everyone is different and that how people want to work and deliver at their best is different for everyone too. In this role, you can expect the following working conditions: Remote work: Work in a way that allows you to work from home and have time onsite when needed to connect with other team members and business leaders Working For You Perks and rewards designed for you: Health and Welfare Benefits: Our health and welfare benefits can be tailored to fit you and your family's needs and start on the first day of employment. Retirement Savings: We will support you as you save for your future. Employee Discounts: We offer you access to a vast selection of global, national, and local discounts on merchandise, services, travel, and more. Career Growth Opportunities: We help you thrive, so together, we can grow. We provide opportunities to advance your career with a vast portfolio of businesses and a global footprint. Paid Training: Earn while you learn and continue to grow with access to award-winning learning platforms throughout your Conduent career. Paid time off: We provide attractive paid time off packages designed for you to enjoy your life away from work. Great Work Environment: We are proud of our award-winning culture and the recognition we’ve received for our diversity efforts. Join Us At Conduent, we are one team, one mission. We understand that our success is directly related to the success of our associates. We strive to create a culture where you can: * Bring your authentic self to work. * Grow and thrive, both personally and professionally. * Make a difference with our clients, in our communities, and with the millions of people we support. When you join Conduent, you are engaged in creating the future - both our company’s and your own. With more than 60,000 associates across 24 countries, we will provide you the opportunity to grow with a team of people who will challenge and inspire you to be the best! Pay Transparency Laws in some locations require disclosure of compensation and/or benefits-related information. For this position, actual salaries will vary and may be above or below the range based on various factors including but not limited to location, experience, and performance. In addition to base pay, this position, based on business need, may be eligible for a bonus or incentive. In addition, Conduent provides a variety of benefits to employees including health insurance coverage, voluntary dental and vision programs, life and disability insurance, a retirement savings plan, paid holidays, and paid time off (PTO) or vacation and/or sick time. The estimated salary range for this role is $70,956 - $92,150. Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on them. You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day. Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law. For US applicants: People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by submitting their request through this form that must be downloaded: click here to access or download the form [https://downloads.conduent.com/content/usa/en/file/conduent-applicant-adaaa-referral-form.pdf]. Complete the form and then email it as an attachment to FTADAAA@conduent.com [FTADAAA@conduent.com]. You may also click here to access Conduent's ADAAA Accommodation Policy [http://downloads.conduent.com/content/usa/en/document/cdt_adaaa_accommodation_pol.pdf].

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Responsibilities

Lead the gathering and documentation of requirements for Medicaid pharmacy claims and MMIS processing. Partner with technical teams and vendors to translate regulatory needs into functional specifications and support the full testing lifecycle.