TDM MMIS (Medicaid Management Information System)

Required:

• 10+ years of overall IT experience
• 5+ years of managerial experience
• Deep functional knowledge of Healthcare processes specially Medicaid Business
• Must have good experience in Reference code/data sets required in Claims adjudication including not limited to CPT, CDT, HCPCS, ICDs.
• Candidate should have hands-on experience on claims processing and Adjudication processes.
• Must have good experience with claims processing concepts, along with the provider, member enrolment and care management concepts.
• Candidate should have hands-on experience and strong knowledge on processing payouts, Account receivables and Receipts creation.
• Must have prior experience or understanding in configuring benefits or programs in claims system across various sub-systems.
• Aware of the Cloud native architecture along with understanding of associated technologies
• Demonstrated understanding of Project Management processes, strategies and methods
• Experience mentoring, coaching and developing rising talent in the technology department
• Excellent time management and organizational skills and experience establishing guidelines in these areas for others
• Strong sense of personal accountability regarding decision-making and supervising department teams
• Experience working in a high-level collaborative environment and promoting a teamwork mentality
• Managerial experience applying analytical thinking and problem-solving skills
• Ability to predict challenges and seek to proactively head-off obstacles
• Exposure to Enterprise architecture/development.
• NoSQL, Microservices, Cloud knowledge