Medicaid Subject Matter Expert (SME)

Job Description:

• Subject matter expertise in Medicaid business processes, systems, and regulations 
• 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.

Required Skills:

• SME in Medicaid with in-depth knowledge of Medicaid business processes, regulations, and systems 
• Experience with Medicaid Management Information Systems (MMIS) or similar healthcare platforms strongly

Preferred:

• Proficient in business process analysis, requirements gathering, and creating detailed documentation 
• Strong written documentation skills
•  Good problem-solving, analytical, and communication skills