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Hybrid Medicaid Subject Matter Expert

Educology Solutions · Concord, Vereinigte Staaten Von Amerika · Hybrid

  • Senior
  • Optionales Büro in Concord
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ESI is seeking a Medicaid Subject Matter Expert to support one of our customers. Work may be performed at various offices throughout New Hampshire.


Duties & Responsibilities



Possess broad knowledge of Medicaid policies and regulations, including the Code for Federal

Regulations that govern IT systems, including but not limited to federal funding, Provider management functions, claims adjudication, program integrity, and third-party liability.


Demonstrate deep understanding of required federal reporting such as CMS-64 and T-MSIS. 


The SME will review system implementation requirements and advise the technical team of requirements and functionality needed for federal compliance.


The SME will assist the IT team in obtaining CMS system certification.

Qualifications



Five (5+) years of experience in Medicaid environments.



Bachelor's Degree


Expertise in federal Medicaid policies and regulations.


Expertise in federal enhanced funding requirements.