Location- Remote- Candidates should be from EST time zone and ready to work as per Manager's requirements.
Linkedin must.
Please share 2 best candidate.
Jd-
Looking for somebody who has solid experience in eligibility, claims, provider, TPL, Prior authorization, Behavioral health, etc.
Prior state experience in the healthcare domain STRONGLY preferred.
Prior SME experience
Need a more rounded BA who has strong knowledge of all Medicaid processes.
Responsibilities
Provides operations and functional expertise in Medicaid in areas such as eligibility, provider data management, claims, third part liability, managed care, Program Integrity, Enterprise data warehouse, etc.
Works with solution specialists and delivery teams to define functional and technical requirements.
Reviews and edits client deliverables to ensure adherence to standards
Defines strategies for prioritizing and sharing information from technical and business SMEs to the broader team
Accurately translates technical knowledge and requirements into clear and concise communications that emphasize business value to clients
Communicates effectively (oral and written) in all aspects of the role
Able to manage requirements and functions related to multiple Medicaid functional areas
Requirements
10+ years' experience in Medicaid systems delivery/operations, requirement management, and implementations
Experience with Medicaid data management and analysis
Highly proficient writer and editor of content and deliverables
Expert oral and written communication
Proficient using Microsoft SharePoint, Word, Excel, PowerPoint, and Teams
Some Technical knowledge of REST APIs and MFTs
Education: Bachelor's or equivalent professional experience
Seniority level
Mid-Senior level
Employment type
Full-time
Job function
Research, Analyst, and Information Technology
Industries
IT Services and IT Consulting
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