Technology Solutions Management Consultant
Conduent
full-time
Posted on:
Location Type: Remote
Location: United States
Visit company websiteExplore more
Salary
💰 $101,063 - $130,000 per year
About the role
- Serve as the Subject Matter Expert (SME) for Medicaid claims processing and encounter data systems.
- Provide expert-level knowledge of the Medicaid claims life cycle, including HIPAA X12 transactions (837, 835) and NCPDP formats.
- Collaborate with cross-functional teams (IT, QA, Business Analysts) to ensure accurate implementation of Medicaid requirements.
- Analyze and interpret Medicaid policy changes and translate them into detailed system requirements.
- Support testing, validation, and quality assurance of Medicaid claims software applications.
- Develop and maintain documentation, training materials, and process workflows.
- Participate in audits, compliance reviews, and quality assurance initiatives.
- Provide mentorship and guidance to junior team members and stakeholders.
Requirements
- Bachelor’s degree in healthcare administration, Information Systems, or a related field (Master’s preferred).
- 5+ years of experience in Medicaid claims processing or healthcare IT systems.
- Strong understanding of Medicaid regulations, policies, and managed care programs.
- Proficiency with Medicaid Management Information Systems (MMIS) and encounter data systems.
- Experience with claims adjudication systems and Electronic Data Interchange (EDI).
- Familiarity with CMS guidelines and state-specific Medicaid programs.
- Strong analytical, problem-solving, and communication skills.
- Ability to work independently and manage multiple priorities in a fast-paced environment.
Benefits
- health insurance coverage
- voluntary dental and vision programs
- life and disability insurance
- retirement savings plan
- paid holidays
- paid time off (PTO) or vacation and/or sick time
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
Medicaid claims processingHIPAA X12 transactionsNCPDP formatsMedicaid Management Information Systems (MMIS)claims adjudication systemsElectronic Data Interchange (EDI)data analysisquality assurancedocumentation developmentprocess workflows
Soft Skills
analytical skillsproblem-solving skillscommunication skillsmentorshipcollaborationindependencetime managementorganizational skillsguidanceteamwork