• Act as the primary interface between business, operations, compliance, regulatory and technology teams. • Interpret and translate SUSEP regulatory requirements, especially those related to the SRO, into functional and technical requirements for development. • Create user stories, acceptance criteria, business process flows and functional documentation. • Lead requirement-gathering workshops and refinement sessions with stakeholders. • Support backlog prioritization and management together with the squad. • Perform impact analyses of regulatory changes and system evolutions. • Ensure traceability between requirements, development, testing and deliveries. • Support functional validations and UAT (user acceptance testing). • Promote business analysis best practices and continuous process improvement.

• Leading the design, configuration, and continuous improvement of ERP processes across product management, supply chain, logistics, warehouse, projects, and customer order management. • Acting as the key liaison between business stakeholders and IT, translating operational needs into system enhancements and ensuring successful delivery of ERP solutions. • Maintain and optimize ERP processes and blueprints across regions. • Translate business requirements into functional designs and user stories. • Collaborate with stakeholders to align ERP capabilities with business needs. • Monitor system performance and identify opportunities for improvement. • Coordinate development, testing, and deployment of ERP enhancements. • Lead user acceptance testing (UAT) and support users after go-live. • Work with vendors and partners on upgrades and integrations. • Partner with IT teams and business leaders to deliver ERP solutions. • Maintain documentation and provide training and support to global users.

• Inventory TEA and external data systems to develop a comprehensive, vendor-ready data map. • Document data sources, ownership, formats, dependencies, and data integration requirements. • Assess data quality across systems to identify gaps, inconsistencies, duplications, and standardization needs. • Recommend data cleansing and validation strategies. • Design a scalable data integration strategy that improves data accessibility, interoperability, usability, and long-term sustainability across TEA systems. • Align the data integration strategy with TEA's implementation of the Ed-Fi Data Standard. • Serve as the Business Analyst for OnePlan, gathering, analyzing, and documenting business and system requirements in Modern Requirements format. • Document process flows, skip logic, system interdependencies, and user interface mock-ups. • Translate business and system requirements into clear functional requirements for vendor design and development. • Support broader IDS team workstreams, including LASO, GSA, OneSystem, and other initiatives.

Role Description This individual will play the role of Claims Domain lead for MMIS health care projects. Responsibilities - Drive the claims module and process and provide domain knowledge. - Perform analysis of business requirements. - Design and develop documentation and ensure quality process while coordinating with customers. - Work in a team environment and provide guidance throughout the entire life cycle. - Responsible for meeting customer expectations and troubleshooting problems in the application. - Assist customers in implementation decisions. Qualifications - Minimum of 8+ years of experience in health care experience especially in MMIS domain. - Capability to think out-of-the-box to create new solutions as needed. - Ability to validate Test scenarios and test plans, test data. - Should be able to Review requirements, documentation and create Requirements Traceability matrix (RTM). - Should have excellent communication (written and spoken) skills to engage with different stakeholders like QA/dev team, clients, end users of Clients and Business Units. - Ability to assess current functionality available in a product vis a vis market trends, regulatory requirements to be implemented in future version of the product. - Ability to drive and share the requirements with Technical and Architects regarding product features to be implemented. - Communication: Collaborate with cross-functional teams. Requirements - Candidate should have strong health care domain experience and should have good knowledge of Medicaid and Medicare. - Candidate should have hands-on experience on claims processing and Adjudication processes. - Must have good experience in Reference code/data sets required in Claims adjudication. - Must have prior experience or understanding in configuring benefits or programs in claims system across various sub-systems. - Should be able to run queries and perform basic system analysis, RCA etc. - Should work closely with the client and development team during the stages of development, and conduct demos at completion of milestones, track and close feedback from such demos. - Must have excellent written and spoken communication skills. Should be able to multitask between internal team and clients based on priority tasks. - Work Closely with Dev, architecture and Design teams to define the GUI view and platform requirements, which is the foundation of the product. - In depth understanding of Claims and Claims lifecycle: - Member, Provider, Claim submission – Paper and EDI X12, Adjudication, Payment Cycle (Finance), Reporting. - Claim Types: Professional, Dental, Institutional, Pharmacy, Encounters and Capitation. - Claim Formats: EDI X12 formats like 837P/I/D, X12 formats 835, 834, 270/271, 276/277. - Claim System: Familiarity with systems like CMdS, GHS, Facets and etc. - SQL: To validate data in backend tables (e.g., claim status, payment details, find members/providers, Benefit Plan). - EDI Tools: Validating X12 files. - Interface Testing: Understanding how data flows between systems and formats and use tools like postman. Benefits - 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. - Great Work Environment: We are proud of our award-winning culture and the recognition we’ve received for our diversity efforts. - Remote work: Enjoy the convenience of working from home and maximize your time by unplugging at the end of your workday.