Strong understanding of Medicaid eligibility rules, enrollment lifecycle, renewals,Stacking, notices, and case management processes. Candidate should be comfortable working in fast-paced operational and production support environments.
Numbers & Facts
Location
Atlanta, GA
Description
Required Qualifications
15+ years of experience in Medicaid eligibility and enrollment systems and operations.
Strong understanding of Medicaid eligibility rules, enrollment lifecycle, renewals,Stacking, notices, and case management processes.
Mandatory experience working with large system integrators, healthcare vendors, or state Medicaid programs.
Experience working on large state Medicaid programs and integrated eligibility systems.
Experience supporting Medicaid modernization or eligibility transformation initiatives.
Strong analytical, problem-solving, and communication skills.
Experience working with business and technical teams in Agile and/or Waterfall environments.
Ability to analyze large datasets and identify operational or system issues.
Experience with defect triage, production support, and operational stabilization activities.
Preferred Qualifications
Experience with platforms such as Pega, Curam, Salesforce, or other eligibility systems.
Knowledge of CMS, ACA, MAGI, and state Medicaid compliance requirements.
Familiarity with healthcare interoperability and data exchange processes.
Experience supporting call center operations, renewals, and eligibility reconciliation efforts.
SQL or PowerBI experience required.
Additional Information
Experience working directly with state agencies is highly preferred.
Candidate should be comfortable working in fast-paced operational and production support environments.
Ability to lead discussions with executive stakeholders and operations leadership is desirable.