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Business Analyst- PA Prior Authorizations expertise

LanceSoft

Job Location:

Quincy, WA - USA

Hourly Salary: USD 64 - 64

Posted: 24 October 2026 (13 hours ago)

Application Deadline: 21 January 2027

Vacancies: 1 Vacancy

Job Summary

Title: Business Analyst- PA Prior Authorizations expertise
Duration: 12 months
Work Hours: 37.5 Hrs/week
Location: 1 ENTERPRISE DRIVE Quincy Massachusetts 02171
Position: Hybrid

The client is seeking to hire a Business Analyst- PA Prior Authorizations expertise to join our collaborative Medicaid Management Information System (MMIS) team. The Business Analyst (BA) will work on our established Provider Reimbursement and Claims processing functional areas to support the development testing and implementation of projects and enhancements to meet the business objectives of the MassHealth (Massachusetts Medicaid) program specifically projects to support the member community. BA should be well versed in health plan management operational concepts and the systems development lifecycle. Preference will be given to candidates with Medicaid systems experience well as claims and business knowledge of the MassHealth BA must have sufficient knowledge of the entire scope of the health care business systems and excellent knowledge in the Claims Processing area including PA. PAS and Referrals. to ensure that the development and testing work within their functional area is compatible with the MMIS system. The BAs primary responsibility is to ensure that the implemented coding scheme meets the requirements of the business community and conforms to all applicable Federal and state laws. The BA will be called upon to act as an active member in all phases of the project including gap analysis requirements gathering design and development activities documentation testing implementation and stabilization. The BA will be expected to work independently as part of a team as well as with business stakeholders so excellent communication and documentation skills is a requirement for this job. Knowledge of Interoperability and X.12 emerging standards is beneficial. The primary work location for this role will be at 1 ENTERPRISE DRIVE Quincy Massachusetts 02171. The work schedule for this position is Monday thru Friday 9:00AM to 5:00PM. This position is expected to follow a hybrid model of reporting to work that combines in-office workdays and work from home days as needed. Schedules are subject to change based on the operational needs of the business.

DETAILED LIST OF JOB DUTIES AND RESPONSIBLITIES:

Lead and participate in joint application design session with stakeholders
Knowledge of SDLC and Agile methodology a plus
Develop test strategies test scenarios and test cases based on written requirements
Execute and review test runs and sign off on testing components
Document requirements and participate in their development and testing
Support the development of end-user training materials and end-user documentation as required.
Possible oversight role during the stabilization phase of each release including the monitoring of system change execution the development of system fix strategies and the close monitoring of the implementation of those strategies
Work with vendors to ensure business requirements are fully defined and tested.
Communicate updates and changes to impacted stakeholders
Represent MMIS in business meetings as needed
Support program staff vendors and other stakeholder with MMIS related questions or concerns.
Provide back up to other business analysts as needed.
Data query and analysis.

Preferred Qualifications:

Proficient in business analysis to support all stages of system project lifecycle

Competency in HIPAA claims and payment transaction processing
Strong data analysis skills- SQL proficient
Excellent communication and documentation skill
Excellent interpersonal skills necessary to interact effectively with project managers developers business analysts systems analysts SQA analysts business users/stakeholders and data processing personnel; as well as interact with representatives from external agencies and companies.
Demonstrated ability to work independently as well as within project teams providing relevant system analysis services.
Highly analytical with the ability to independently analyze document findings and recommend solutions.

Education and Certifications:

Bachelors degree or higher in Business IT or Healthcare administration with minimum 3 years experience or equivalent in healthcare administration setting

EEO Employer
LanceSoft is a certified Minority Business Enterprise (MBE) and an equal opportunity employer. We prohibit discrimination and harassment of any kind based on race color sex religion sexual orientation national origin disability genetic information pregnancy or any other protected characteristic as outlined by federal state or local laws.
This policy applies to all employment practices within our organization including hiring recruiting promotion termination layoff recall leave of absence compensation benefits training and apprenticeship. LanceSoft makes hiring decisions based solely on qualifications merit and business needs at the time.

Required Experience:

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