Medicaid jobs in Richmond, VA

Remote

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7d ago

Position- HRSN Medicaid Claims Analyst Type- 100% Remote (PST Hours) Visa- No H1 What you'll do: Review and resolve HRSN claims assigned through QNXT work queues including rent, rental arrears, utility assistance, storage, and housing support claims. You'll analyze pended, denied, and audit-flagged claims, correct claim data, resolve QNXT edits, review potential duplicate submissions, and move valid claims through adjudication and payment. Much of the initial work focuses on reducing the existin

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Contract, Third Party

Depends on Experience

Scrum Master with Medicaid - Remote

Remote

•

Yesterday

Atleast 8 -10 years of industry experience as a Scrum Master. Must have exp with Medicaid or MMIS Facilitate daily standups (or the daily scrum) as needed. Participate in the meeting and capture feedback. Note areas for improvement and action items for future sprints. Work as the administrator of the scrum board. Ensure that cards are up to date and the scrum tool, is working well. Meet individually with team members and stakeholders as needed. Iron out team disagreements about process and work

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Contract, Third Party

Depends on Experience

Technical Business Analyst (Healthcare Claims Domain and Medicaid/MMIS, Overall 10+ years of experience)

Remote

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3d ago

Job Description: Job Title: Technical Business Analyst (Claims Domain, MMIS) Location: Remote Type: Full Time/W2 with Infinite Computer Solutions Job Description: Play the role of Claims Domain lead for MMIS health care projects. Drive the claims module and process, domain knowledge, performs analysis of business requirements, designs and develops documentation, ensures quality process, coordinates with customers. Works in team environment and provides guidance throughout the entire life cycle.

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Full-time

$70,000 - $95,000

Technical Project/Delivery Manager With Medicaid Experience - Remote

Remote

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3d ago

Required:15+ years of overall IT experience5+ years of managerial experienceDeep functional knowledge of Healthcare processes specially Medicaid BusinessAware of the Cloud native architecture along with understanding of associated technologiesDemonstrated understanding of Project Management processes, strategies and methodsExperience mentoring, coaching and developing rising talent in the technology departmentExcellent time management and organizational skills and experience establishing guideli

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Contract, Third Party

$61

CMS Medicaid Certification & Compliance Project Specialist

Remote

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7d ago

CMS Medicaid Certification & Compliance Project Specialist The Specialist will work closely with Business Leads, Project Teams, matrix managers, vendors, CMS and MITRE teams, and other stakeholders to ensure certification activities are properly coordinated, documented, and completed on schedule. This is a new position created to provide direct support for sensitive state certification processes and high-visibility MES projects. ResponsibilitiesSupport project teams in executing CMS Medicaid cer

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Contract

$50 - $55

Healthcare QA Tester (8+ year experience in MMIS, Healthcare, Medicaid and Claims)

Remote

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3d ago

Job Description: Job Title: IT Testing Engineer II (MMIS/Claims) Location: Remote Type: Full Time/W2 with Infinite Computer Solutions Job Description: (Min 3-8 Years of Exp) Key Responsibilities Gather requirements and scenarios from Development Team, Business Analyst and other stakeholders.Work closely with Project Management Team during design phase. Prepare detailed Test Scenario & Test casePerform hands-on functional and web UI testing Create and maintain test scripts, plans, and casesCondu

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Full-time

$70,000 - $80,000

Lead, Medicaid Technology

Remote or Oklahoma

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Today

Become a part of our caring community The Lead for Medicaid Technology is responsible for driving end-to-end technology delivery for Medicaid initiatives. This role ensures successful implementation of use cases across multiple horizontal platform owners, aligning with regulatory requirements and enterprise architecture standards. The leader will serve as the primary technology point of contact for Medicaid, orchestrating cross-functional collaboration to deliver compliant, scalable, and innovat

Full-time

USD 117,600.00 - 161,700.00 per year

MMIS (Medicaid Management Info Systems) Domain Lead

Remote

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4d ago

We are seeking to hire a MMIS (Medicaid Management Information Systems) Domain Lead with expertise in Medicaid Pharmacy, to join our teams working on a new multi-year awards we have within several State Govt clients, modernizing their Medicare/Medicaid systems. These roles are 100% remote. Being a US Cit is required for working on this program. This position pays a strong salary package with full benefits (including choice of healthcare plans, dental, vision, life insurance, 3 weeks PTO, 11 Pai

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Full-time

Depends on Experience

Senior Project Manager – Medicaid Technology & Operations

Remote or Hybrid in California City, California

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8d ago

Senior Project Manager Medicaid Technology & OperationsLocation: Hawaii Key Responsibilities Strategic Project LeadershipOversee planning and implementation of major projects, managing scope, timelines, and budget.Guide complex, large-scale initiatives that support strategic business objectives.Define project scopes and objectives with relevant stakeholders.Planning, Execution & MonitoringDevelop detailed project plans, including resource needs, schedules, and cost structures.Monitor project pe

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Full-time

Depends on Experience

MMIS (Medicaid) Data Conversion Manager

Remote

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4d ago

We are seeking to hire a MMIS (Medicaid) Data Conversion Manager with expertise in MMIS and MES implementations, to join our teams working on a new multi-year awards we have within several State Govt clients, modernizing their Medicare/Medicaid systems. These roles are 100% remote. Being a US Cit is required for working on this program. This position pays a strong salary package with full benefits (including choice of healthcare plans, dental, vision, life insurance, 3 weeks PTO, 11 Paid Federa

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Full-time

Depends on Experience

Sr Business Analyst / Trainer with Medicaid Pharmacy / PBM expertise

Remote

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4d ago

We are seeking to hire a Sr Business Analyst / Trainer with expertise in Medicare/Medicaid Pharmacy, including specific expertise in PBM (Pharmacy Benefits Management), to join our teams working on a new multi-year awards we have within several State Govt clients, modernizing their Medicare/Medicaid systems. These roles are 100% remote. Being a US Cit is required for working on this program. This position pays a strong salary package with full benefits (including choice of healthcare plans, den

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Full-time

Depends on Experience

MMIS (Medicaid Provider) Integration & Analytics Delivery Manager

Remote

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4d ago

We are seeking to hire a MMIS (Medicaid) Provider Integration & Analytics Delivery Manager with expertise in Medicaid Provider+ implementations, to join our teams working on a new multi-year awards we have within several State Govt clients, modernizing their Medicare/Medicaid systems. These roles are 100% remote. Being a US Cit is required for working on this program. This position pays a strong salary package with full benefits (including choice of healthcare plans, dental, vision, life insura

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Full-time

Depends on Experience

NCDIT - Project Manager/Medicaid Program Administrator

Remote

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14d ago

Project Manager/Medicaid Program Administrator (Remote) Primary Location: Remote V-Soft Consulting is currently hiring for a Project Manager/Medicaid Program Administrator (Remote) for our premier client. Education and Experience Contract development, administration, and monitoring: 3 years.Budget development, administration, and monitoring: 3 years.Implementing data governance and exchange and associated documentation according to state and federal regulations: 3 years.Coordinating staffing n

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Contract

Depends on Experience

Functional Business Analyst with SNAP, TANF, QHP, Medicaid/Medicare programs exp - 100% Remote - W2

Remote

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12d ago

WHO WE ARE: Founded in 2007, DTI (Diversified Technology, Inc.) is a successful African American owned IT Consulting/Staffing firm based in Chicago''s Loop. WHAT WE DO: We focus on providing delivery, staffing, and supported services such as enterprise integration/implementations including, but not limited to, CRM, EAM, ERP, PMO, and QA. We service clients in SLED (state/local gov''t & education), financial services, fortune, public utility, as well as regularly partnering with Big 4 SI partner

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Contract

40 - 40

ITX Developer

Richmond, Virginia

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Today

JOB TITLE: ITX Developer JOB LOCATION: Remote but must be open to travel for the project to Alpharetta, GA when needed WAGE RANGE*: $50hr to $55hr JOB NUMBER: 26-00996 REQUIRED EXPERIENCE: Knowledge of all ANSI X12N 5010 transaction sets, including IBM ITX map development, EDI translation, HIPAA/X12 validation, compliance validation rule implementation, and EDI integration solutions. JOB DESCRIPTION We need a Senior developer to act as lead COTS team member for a multiple Medicaid states req

Full-time

USD 50.00 per hour

Business Analyst - CMdS Claims, Member & Finance Implementation (MES)

Richmond, Virginia

•

Today

JOB TITLE: Business Analyst - CMdS Claims, Member & Finance Implementation (MES) JOB LOCATION: Remote WAGE RANGE*: $50-60/hr JOB NUMBER: 26-01186 REQUIRED EXPERIENCE: Required qualifications 12+ years business analysis experience in Medicaid MMIS / MES, with deep hands-on work in at least two of: Claims, Member/Eligibility-Enrollment, Finance/Financial Accounting. Proven experience developing and implementing claims systems / MMIS / MES platforms, such as Conduent CMdS (Conduent Medicaid Sui

Full-time

USD 50.00 - 60.00 per hour

Senior Health Actuary

Remote

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4d ago

Job Title:Senior Consulting Actuary Job Details: Client is dedicated to supporting decision-makers in state government healthcare agencies, mission-driven organizations, and other public and private sector organizations. Our team brings together deep expertise in actuarial science, health economics, data science, policy analysis, healthcare financing, and advanced analytics to help clients address complex questions involving healthcare financing and payment, cost and risk, program performance, a

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Full-time

200,000 - 230,000

Test Lead (State Integrated Eligibility)

Remote

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6d ago

Required Skills & Experience 8+ years of overall testing experience, with strong functional testing focus3+ years as a Test Lead managing teams of 6 8 testersHands-on experience with State Integrated Eligibility (IE) systemsEnsure coverage across IE programs such as Medicaid, SNAP, TANF, Child CareStrong understanding of eligibility determination workflows and cross-program integrationExperience working on state government / public sector projectsExpertise in SDLC and STLC, including Agile and/o

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Full-time

Depends on Experience

AS400/Synon/RxClaim Tech Lead

Remote

•

Today

Job title: AS400/Synon/RxClaim Tech Lead Role is remote Years of experience required: SYNON (8+years) and Rxclaim adjudication experience (min 3 years) Mandatory skills: 1.SYNON 2.Healthcare Pharmacy claims adjudication and pricing 3. COBOL/400 We are seeking technical lead with 8+ years of experience to join our team. The ideal candidate will have expertise in SYNON, AS400 along with domain experience in Medicare & Medicaid Claims, Claim Adjudication and pricing knowledge This role requires a p

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Contract

$60 - $70

Sr PySpark Developer

Remote

•

Today

Senior PySpark Developer (Cloudera, Iceberg, Airflow & AWS) Location: Remote Job Description We are seeking a highly skilled Senior PySpark Developer to support a large-scale cloud transformation initiative focused on building modern data platforms on Cloudera, Apache Iceberg, Airflow, and AWS. The role will be responsible for designing, developing, and optimizing scalable data pipelines that ingest, transform, and process large volumes of enterprise data. The successful candidate will work clos

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Contract

Depends on Experience

Medicaid jobs in Richmond, VA, USA