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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in business analysis, including requirements gathering, documentation, and stakeholder facilitation, particularly within Medicaid and public-sector healthcare programs. Proficient in SQL for data analysis and validation, with strong communication and organizational skills to manage competing priorities effectively.
Highest-signal resume keywords
Business AnalysisSQL Data AnalysisMedicaid Program ExperienceRequirements DocumentationStakeholder Facilitation
Tech Stack
Tools & technologiesAbout the role
Key responsibilities & impact- Gather, document, and manage business requirements for EDW reports, extracts, and enhancements, including CMS-64/CMS-21, MARS, T-MSIS, and PERM support
- Analyze current business processes and systems and document requirements for new or changed processes
- Translate federal and State Medicaid policy and reporting guidance into business rules and requirements
- Write business requirements, business rules, use cases, user stories, acceptance criteria, data mappings, and process flows
- Maintain requirements traceability through design, testing, and delivery
- Facilitate working sessions with State business users, Optum technical teams, and other partners
- Capture meeting minutes, decisions, action items, and follow-ups
- Track questions, dependencies, and risks and escalate issues when needed
- Write SQL to profile and analyze Medicaid enrollment, eligibility, provider, claims, encounter, and financial data
- Identify and document data anomalies and variances and collaborate with ETL, BI, and QA teams on resolution
- Share use cases with data and quality analysts, review profiling results, and confirm alignment with requirements and Medicaid/CMS guidelines
- Support testing and UAT, including test scenarios, acceptance criteria, defect reporting, and follow-up
- Prepare presentations, summaries, and status updates for leadership and customers
- Maintain business documentation, data definitions, the Operations Guide, and process documentation in SharePoint and Azure DevOps
- Support end-user training and training materials
- Mentor junior analysts and serve as backup to the Medicaid SME
- Peer review project artifacts and help manage intake and change requests, including impact analysis and BA effort estimates
Requirements
What you’ll need- Bachelor’s degree in business, information systems, public health, or a related field, or equivalent experience
- 8+ years of business analysis experience, including requirements gathering, documentation, stakeholder facilitation, and user acceptance testing
- 5+ years of experience working with healthcare data such as claims, encounters, eligibility/enrollment, provider, or financial data
- 3+ years of experience with Medicaid or public-sector healthcare programs
- 3+ years of experience writing SQL to analyze and validate data in a relational database or data warehouse
- Understanding of Fee for Service and managed care claim adjudication
- Basic understanding of CMS reporting requirements for Medicaid
- Experience writing use cases, user stories, and acceptance criteria and supporting testing/UAT
- Experience facilitating meetings and documenting outcomes
- Proficient in MS Word, Excel, PowerPoint, Visio, MS Project, SharePoint, and Teams
- Strong written and verbal communication skills
- Organized and detail-oriented, with ability to manage competing priorities and tight deadlines with limited supervision
- Ability to travel to Springfield, IL up to three times per year or as needed
- Bonus experience with CMS-64/CMS-21, MARS, T-MSIS, PERM, CMS Core Set, HEDIS, CHIPRA, Medicaid/Medicare regulation, ACA, MES/MMIS, Enterprise Data Warehouse DDI, Teradata, SQL Assistant/Query Studio, Business Objects, Tableau, Power BI, ETL, Microsoft 365, Azure DevOps, JIRA, Agile/Scrum, and CBAP, CCBA, or PMI-PBA certification
Benefits
Comp & perks- Purposeful projects improving systems that serve real people
- People-first culture with support, autonomy, and community
- Strategic, hands-on work
- Collaborative work with clients and teams
- Meaningful work and opportunities for career growth
- Fully remote work arrangement
- Travel to Springfield, IL up to three times per year or as needed
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Requirements GatheringSQL WritingData MappingUse Case DevelopmentUser Acceptance TestingBusiness Rules DocumentationProcess Flow DocumentationData Anomaly IdentificationTesting SupportHealthcare Data Analysis
Soft Skills
Strong Communication SkillsOrganizedDetail-OrientedAbility to Manage Competing PrioritiesMentoring
Tools & Technologies
MS WordExcelPowerPointVisioMS ProjectSharePointAzure DevOpsJIRATableauPower BI
Certifications & Qualifications
CBAPCCBAPMI-PBA
Industry Keywords
MedicaidCMS ReportingHealthcare DataFee for ServiceManaged CareClaims AdjudicationPublic HealthEnterprise Data WarehouseETLAgile/Scrum