Job Description

Project / Program

FACTS, PADS and OMIG System Enhancements

The Fraud Activity Comprehensive Tracking System (FACTS) is an electronic drawer, composed of numerous and varying databases and interfaces that permit efficient access to current and historical information on all audit and investigative
activities involving Medicaid providers and/or recipients. The application is web based and is accessible in real-time by over 1,200 users across the State in five state agencies (OMIG, DOH, AG (MFCU), OSC & CQC). The FACTS system is comprised of over 30 related modules.
There are several maintenance and system enhancements that will be addressed including, but not limited to: FACTS enhancements, PADS, Managed Care enhancements, audit sampling and legal.

Day to Day Tasks

- Analysis of system requirements.
- Meeting with business users.
- Designing system prototypes.
- Creating logical data models.
- Creating use cases.
- Documenting existing and proposed systems within the context of a business analyst development suite.
- Writing complex SQL against the MDW.

Mandatory Qualifications

Systems Analyst - Specializes in analyzing, designing and implementing information systems. Assesses the suitability of information systems in terms of their intended outcomes and liaises with end users, software vendors and programmers in order to achieve these outcomes. Uses analysis and design techniques to solve business problems using information technology. Serves as change agent, who identifies the organizational improvements needed, designs systems to implement those changes and trains and motivates others to use the systems.

Expert - 84+ Months: Candidate is able to provide guidance to large teams and/or has extensive industry experience and is considered at the top of his/her field.

Requested Qualifications
 
- 84 MONTHS Experience in system/business analysis providing executive level and operational guidance to a diverse group of users, technicians, and managers within a health care entity that deals with claims-based data sets. Must include:
• Experience with HIPAA Confidential data and New York State/Federal regulations.
• Experience writing complex SQL against the MDW
• Creating/optimizing advanced SQL queries against large relational data sets.
• Experience using Balsamiq for wireframe and screen design
• Analysis of system requirements
• Meeting with business users
• Designing system prototypes
• Creating logical data models
• Creating use cases
• Documenting existing and proposed systems within the context of a business analyst development suite
- 84 MONTHS Experience with managing the development and implementation of Medicaid Audits/ Investigations case management systems, in a Microsoft. Net/Java platform and/or MS SQL/Oracle back-end environments.
- 84 MONTHS Experience implementing, managing and troubleshooting electronic documents solutions, third-party APIs interfaces and OCR engines, and Xerox Docushare as the enterprise electronic document content repository.
- 72 MONTHS Experience managing and supporting Medicaid audit work-papers documentation systems, involving case replication, sampling, reporting, recipient claims, findings, utilizing Microsoft .Net/C# technology.
- 24 MONTHS Experience documenting the design of applications which utilize ComponentOne, Aspose, and Mathematica software.
- Education/Certification: Master's or higher degree