Business Analyst (Integrated Eligibility

Business Systems Analyst - Eligibility Policy & Benefit Calculation (EDBC) SME

Engagement: Contract, long-term (multi-year state program

)Start: ASAP (actively interviewing

)

Location:

Onsite in Des Moines, Iowa strongly preferred. Open to candidates willing to relocate to Des Moines; relocation supported and several team members have already relocated

.Travel: Local or relocated candidates work onsite with the team at the client’s Des Moines office

.Interview Process: Interview with the Eligibility Manager and a Senior Manager / functional lead; follow-up conversation as needed

.
About the Clie

ntA leading professional services firm delivering large-scale Health and Human Services (HHS) technology modernization programs for state government agencies. This engagement is a multi-year integrated eligibility system implementation supporting Medicaid, SNAP, and other public assistance programs. It is a high-visibility program with direct state stakeholder interaction and real impact on how benefits reach citizen

s.
About the Initiat

iveThis is a long-horizon, multi-track integrated eligibility (IE) modernization program with a decade-long delivery runway. The program is organized into functional threads, including eligibility, conversion, notices and correspondences, customer and worker portals, interfaces, and batch processing. The team is currently in the design phase and moving toward pilot and statewide rollout, and is building out a dedicated local team at the client’s Des Moines office.

The environment is intentionally fluid: people rotate across threads as the program advances, which creates strong long-term growth and mobility opportunities for contractors who deliv

er.
Role Sum

mary

This Business Systems Analyst is the eligibility policy and benefit calculation SME for a state HHS solution. This person owns how eligibility actually works: the workflows, the policy, and the calculations that determine benefits for programs such as Medicaid and SNAP, including household composition, income determination, and, critically, the sequence in which eligibility policy and rules execute to reach a determination.

This is a business analyst role, not a developer role. The right person is deeply fluent in eligibility policy and how it must behave in the rules engine (for example, OPA), and can read, validate, and functionally own the rules and their outcomes without needing to be the person who codes t

hem.
Key Responsibil

ities

Eligibility Policy and Benefit Calcul

• ation
  
  Own the eligibility determination and benefit calculation logic for programs such as Medicaid and SNAP: how household composition, income, and program rules combine to produce an accurate determina
• tion.
  
  Map, validate, and document the sequence in which eligibility policy and rules execute, including order of operations, program hierarchy, and cross-program dependencies, so determinations run correctly end to
• end.
  
  Translate federal and state eligibility policy into clear, testable rules and calculations, and validate how those rules are expressed in the rules engine (for example, OPA) as the business and functional owner, not the devel
• oper.
  
  Analyze eligibility discrepancies and trace benefit mismatches back through the policy logic, calculation sequence, and configuration to root cause, then drive resolu

tion.

Requirements and Functional D

• esign
  
  Drive fit/gap analysis, requirements refinement, and functional decision-making for eligibility l
• ogic.
  
  Partner directly with state stakeholders to confirm policy interpretation and validate system behavior against regulatory intent and compliance requirem

ents.

Testing and Qu

• ality
  
  Design and maintain eligibility test scenarios covering standard determinations, edge cases, household composition variations, income thresholds, and program interact
• ions.
  
  Support SIT/UAT for eligibility, ensuring end-to-end scenario coverage, traceability to policy, and defect triage for eligibility-related is

s.Collaboration and SME Su

• pport
  
  Serve as the go-to SME and escalation point for eligibility logic questions across the
• team.
  
  Collaborate with functional leads, configuration and rules developers, and technical architects so the design supports…