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*This is an exempt position. Salary commensurate with experience*
Job Title: SQL / Medicaid Functional Consultant
Location: Albany, NY (Hybrid)
Duration: 12 Months (with potential for extension)
Start Date: estimated - 9/14/26
W2 Hourly Rate: $68-$88/hour
Application Deadline: 8/28/26
Overview:
We are seeking a SQL / Medicaid Functional Consultant who will support our NYS client. This role supports the Enrollment track of a New York State Medicaid LTSS modernization program, with a focus on requirements, functional solution design, and HIPAA 834 and 278 transaction interchanges. The consultant will work with State, MCO, vendor, development, and QA stakeholders to support accurate enrollment, interfaces, testing, and issue resolution.
Duties: - Gather, analyze, and document business and functional requirements for the Enrollment track of the Medicaid LTSS modernization program.
- Develop and maintain BRDs, FRDs, process flows, data mappings, and interface specifications that clearly articulate functional solution requirements.
- Support HIPAA 834 and 278 transaction interchanges, including analysis of segments, loops, code sets, companion guides, and eMedNY inbound/outbound transactions.
- Use SQL and basic data analysis to support enrollment reconciliation, transaction validation, defect investigation, and issue resolution.
- Partner with State, MCO, vendor, development, and QA stakeholders on requirements clarification, testing support, and defect triage.
Mandatory Qualifications:
- 4+ years of experience as a Business / Functional Consultant in healthcare and/or public sector programs.
- 2+ years of SQL experience.
- 2+ years of Medicaid experience.
- 1+ years of recent Medicaid and LTSS knowledge, including enrollment and managed care.
- Hands-on experience with HIPAA 834 or 278 transactions, including segments, loops, code sets, and companion guides.
- Experience with NY eMedNY and related inbound/outbound transaction interchange.
- Ability to produce BRDs, FRDs, process flows, data mappings, and interface specifications.
- Strong client-facing communication skills with the ability to work with State, MCO, and vendor stakeholders.
- Experience partnering with development and QA teams on requirements clarification, testing, and defect triage.
- Proficiency with JIRA, Confluence, Visio, and MS Office.
Desirable Qualifications: - Experience supporting both HIPAA 834 and 278 transactions.
- 3+ years supporting Enrollment on a Medicaid platform.
- Work experience with eMedNY.
- Familiarity with Managed Long Term Care enrollment concepts and non-MAGI workflows.
- SQL/basic data analysis for reconciliation and defect investigation.
Ready to make a difference?
We’re eager to connect with qualified candidates committed to delivering results and fostering excellence within client projects.
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Ready to make a difference?
We’re eager to connect with qualified candidates committed to delivering results and fostering excellence within client projects.
Cloud and Things complies with all applicable federal, state, and local laws regarding recruitment and hiring. All qualified applicants are considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status, or any other category protected by applicable federal, state, or local laws.
AI-Assisted Resume Evaluation Notice
Cloud and Things – Talent Management
Notice to Candidates
Cloud and Things utilizes artificial intelligence (AI) tools to assist our recruiting team in evaluating candidate applications for streamlining; consistency, efficiency, and thoroughness. All hiring decisions are ultimately made by our human recruiting professionals.
How AI Is Used
Our AI tools assist by:
Analyzing resumes against job requirements Supporting our recruiters in candidate data evaluation Ensuring consistent review standards across all applications Important: AI serves as a support tool only. As noted above, all candidate selection and hiring decisions are made by experienced human recruiters. Your unedited resume will be processed by our AI tools as part of this evaluation.
Desirable Qualifications:
Experience supporting both HIPAA 834 and 278 transactions. 3+ years supporting Enrollment on a Medicaid platform. Work experience with eMedNY. Familiarity with Managed Long Term Care enrollment concepts and non-MAGI workflows. SQL/basic data analysis for reconciliation and defect investigation.
Mandatory Qualifications:
4+ years of experience as a Business / Functional Consultant in healthcare and/or public sector programs. 2+ years of SQL experience. 2+ years of Medicaid experience. 1+ years of recent Medicaid and LTSS knowledge, including enrollment and managed care. Hands-on experience with HIPAA 834 or 278 transactions, including segments, loops, code sets, and companion guides. Experience with NY eMedNY and related inbound/outbound transaction interchange. Ability to produce BRDs, FRDs, process flows, data mappings, and interface specifications. Strong client-facing communication skills with the ability to work with State, MCO, and vendor stakeholders. Experience partnering with development and QA teams on requirements clarification, testing, and defect triage. Proficiency with JIRA, Confluence, Visio, and MS Office.
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