Medicaid Management Information Systems - (MMIS) - Remote- United States - Full Time Role

Hybrid • Posted 25 days ago • Updated 9 days ago

Full Time

Remote

Fitment

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Job Details

Skills

Project Management
Business Analysis
Quality Management
Content management
communication skills
Data Analytics
Functional design
Business Processes
Medicaid
systems integration
Consulting
Regulatory Compliance
Decision Making Skills
Interoperability
Auditing Skills
Technology Strategies
Insurance Claim Processing
Systems Design
Analytical Procedures
Business Informatics
Fast Healthcare Interoperability Resources
Health Administration
Health Informatics
Medicaid Management Information Systems (MMIS)
Streamline

Summary

Role: MMIS (Medicaid Management Information Systems)

Key Responsibilities & Skills

System Modernization: Transitioning legacy, monolithic MMIS to modern, modular Medicaid Enterprise Systems (MES).
Functional Expertise: Deep knowledge of Medicaid claims, provider enrolment, third-party liability (TPL), pharmacy benefits, and member management.
Regulatory Compliance: Ensuring system functionality meets federal and state Medicaid regulations.
Project Leadership: Guiding IT teams, developers, and business analysts in system requirements and testing.
Data Analysis: Using data to prevent fraud, waste, and abuse, and improving program performance.

Required Qualifications:

Experience in designing and building MMIS (Medicaid Management Information Systems) part of Medicaid Enterprise Systems (MES).
Involved in System Integration, Data Analytics and Interoperability initiatives and deep understanding of state Medicaid systems.
Looking for an MMIS (Medicaid Management Information System) domain expert who is a SME with deep, specialized knowledge of the technology, regulations, and business processes used by state governments to manage Medicaid programs.
Should have a deep understanding of and be able to bridge the gap between technical teams and state policy, ensuring compliance with federal (CMS) guidelines and streamlining operations like claims processing, provider enrolment, and eligibility verification.

Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.

Dice Id: 10120137
Position Id: 2026-67001/379757
Posted 25 days ago

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