Lead Systems Analyst Needed in Santa Ana, CA only USC, GC and GC-EAD


Good morning! I have a Lead Systems Analyst position that could sit in either Santa Ana, CA or Eden Prairie, MN. This is a Contract to Hire position and will only consider candidates who are eligible for hire (GC, US Citizens, GC EAD). Please DO NOT send H1B or EAD OPT candidates.

Location: Santa Ana, CA (preferred) or Eden Prairie, MN (secondary)
Duration: Contract to Hire (6-12+ Months)
Mode of Interview: Phone/On-Site

looking for 6+ profiles.


Our client is making a major capital investment to build a new product solution for the Medicaid fee for service claims market. The industry traditionally refers to these as Medicaid Management Information Systems (MMIS). 

Primary Responsibilities: 
• Contribute to the product development efforts for one or more of the functional domains outlined below to meet the Medicaid Management Information System (MMIS) market and operational needs: 
o Member Management 
o Claims Processing 
o Constituent Services (Portals, CRM, Contact management, etc.)
o Financial Management 
• Evaluate business requirements and prepare the detailed functional and technical specifications that follow project guidelines and Optum standards 
• Communicate design to all stakeholders and varying levels of the organization 
• Work closely with the Engineering team in delivering a solution that meets the defined requirements 
• Collaborate with QA team to ensure testing efforts align with functionality 
• Maintains up-to-date knowledge of current trends in Government Information Technology solutions, issues in healthcare, national and statewide standards and legislation's, and changing policies and procedures 

Required Qualifications: 
• 5+ years of experience in playing a business/functional/systems analyst in defining system functionality and delivering system capabilities to meet market / business needs 
• 3+ years In-depth knowledge of one or more of the functional domains specified above 
• Proficiency with Requirements Management, Agile Development and other SDLC related tools 
• Willingness and ability to travel up 25% to in the US 
• Bachelor's Degree or equivalent work experience 

Preferred Qualifications: 
• Specific MMIS experience in one or more of these functional domains specified above 
• Hands on experience with structured SDLC methodologies preferably Agile 
• Ability to work independently with limited general supervision. 
• Strong technical and non-technical communication skills 


  • Provider: Health Plan or MMIS experience with Provider management, provider enrollment 
  • Member: Health Plan or MMIS experience with Member management, member health plan enrollment. Integrated eligibility / insurance experience is somewhat relevant but does not fully meet the need. 
  • Claims: Resource must have either MMIS Claims or Facets Claims experience. Depending on the need, there may be more granular requirements for Claims Entry, Claims Pricing, Claims Adjudication/Editing 
  • Financial: Health Plan or MMIS experience with Financial Management and/or Claims Payment 
  • TPL: MMIS Third Party Liability (TPL) experience. Due to the nuances of Medicaid TPL, non-MMIS TPL experience likely will not suffice 
  • Service Auth / Clinical / Utilization Management Health Plan / MMIS / QIO experience in one / all of these areas. Experience with the Aerial platform is a bonus 
  • Constituent Health Plan or MMIS experience with constituent services – Portals, IVR, Call center, CRM packages. When the CRM solution is determined for OMMS, specific experience with that CRM may be required). 
  • ODS/Reporting Health Plan or MMIS experience collaborating with data architects to design/build operational data stores (ODS) for the purpose of developing/configuring operational reports. 
  • Configuration Facets configuration experience 
  • Technical Technically oriented AWOs/BSAs for areas such as EDI, Document Management, etc. 

Other Must Haves:  In this industry, methods (Agile) can be taught much more quickly than the functional domain complexities. Functional domain experience is paramount. 


Technical Recruiter
Tackle Consulting      

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