Business Analyst — CMdS Claims, Member & Finance Implementation (MES) at The Dignify Solutions, LLC in Edison, NJ
- Company: The Dignify Solutions, LLC
- Location: Edison, NJ
- Posted: Sep 20, 2026
- Type: Contract
- Experience: 10+ years
Overview
Delivery & analysis Own requirements and functional design for assigned 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.
Responsibilities
- Delivery & analysis
- Own requirements and functional design for assigned 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.
- 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 design for payment cycles, budget account / category of service, fund splits, ASO / F/EA and other administrative payment paths, financial transactions, and reporting/accounting controls.
- Produce BRDs, FRDs, process flows, data mapping, gap analysis, and configuration workbooks suitable for build and UAT.
- Work side-by-side with developers on design walkthroughs, edge cases, and defect triage.
- Partner with QA to define test scenarios, expected results, and regression packs (positive/negative, adj/void, crossover, encounter, finance posting).
- Support SIT, UAT, and parallel/run-compare activities against legacy MMIS outcomes.
- Validate that implementations meet Medicaid policy and MES operational readiness (security, audit, reporting, interfaces).
- Run workshops with business owners, SMEs, fiscal, and operations.
- Align designs to CMS MES expectations (modularity, interoperability, standards-based interfaces, certification evidence).
- Support change management: training outlines, release notes, and operational runbooks for CMdS go-live.
Requirements
- >10 years of experience
- Top Skill 1: Medicaid Enterprise Systems (MES)
- Top Skill 2: MMIS / Medicaid / Healthcare
- Top Skill 3: Claims
- Top Skill 4: Business Analyst
- Top Skill 5: Finance
Skills
Required
- Medicaid Enterprise Systems (MES)
- MMIS / Medicaid / Healthcare
- Claims
- Business Analyst
- Finance