Industry SME – Medicaid Provider Data

Provides deep expertise in Medicaid Provider Management, including required data elements,

validation rules, provider types, and common data-quality issues.

• Advises the team on data requirements, dependencies, and regulatory

expectations that shape enrollment and credentialing workflows.

• Evaluates current system architecture to identify impacts related to provider data

capture, transformation, and downstream usage.

• Contributes to defining the future-state data and architectural approach, ensuring

proposed solutions are feasible, compliant, and aligned with real-world provider data

behavior