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Moss Point, Mississippi

•

Yesterday

JOB DESCRIPTION: The Medicaid SME will provide subject matter expertise related to Medicaid program data, policies, and operational workflows to support the successful implementation and operationalization of the Program Integrity (PI) tool. The SME will collaborate with technical teams, program staff, vendors, and project leadership to ensure the PI solution effectively leverages Medicaid data to detect, prevent, and investigate fraud, waste, and abuse. Key Responsibilities: Data Domain Experti

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Contract, Third Party

Depends on Experience

Medicaid Operational SME

Moss Point, Mississippi

•

Yesterday

The Medicaid SME will provide subject matter expertise related to Medicaid program data, policies, and operational workflows to support the successful implementation and operationalization of the Program Integrity (PI) tool. The SME will collaborate with technical teams, program staff, vendors, and project leadership to ensure the PI solution effectively leverages Medicaid data to detect, prevent, and investigate fraud, waste, and abuse. Key Responsibilities: Data Domain Expertise - Provide expe

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Contract, Third Party

Medicaid SME

Moss Point, Mississippi

•

Yesterday

Title : Medicaid SME - Location : Jackson, MS - Onsite Duration : 12 + Months Job Type : C Description : The Medicaid SME will provide subject matter expertise related to Medicaid program data, policies, and operational workflows to support the successful implementation and operationalization of the Program Integrity (PI) tool. The SME will collaborate with technical teams, program staff, vendors, and project leadership to ensure the PI solution effectively leverages Medicaid data to detect, p

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Contract, Third Party

Depends on Experience

Senior Manager, Medicaid Implementations - Provider Data

Remote or Florida

•

Today

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health , you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. Role Summary The Senior Manager, Medicaid Implementatio

Full-time

USD 75,400.00 - 165,954.00 per year

Medicaid Management Information Systems - (MMIS) - Remote- United States - Full Time Role

Remote or Hybrid

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10d ago

Role: MMIS (Medicaid Management Information Systems) Key Responsibilities & Skills System Modernization: Transitioning legacy, monolithic MMIS to modern, modular Medicaid Enterprise Systems (MES). Functional Expertise: Deep knowledge of Medicaid claims, provider enrolment, third-party liability (TPL), pharmacy benefits, and member management. Regulatory Compliance: Ensuring system functionality meets federal and state Medicaid regulations. Project Leadership: Guiding IT teams, developers, and b

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Full-time

Project Manager (W2 Only) - Remote Role

Remote or South Carolina

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10d ago

About this Position: Job Title: Project Manager DAILY DUTIES / RESPONSIBILITIES: Acknowledge and classify incidents based on the severity and adhere escalation steps as defined in the incident management process document. For Severity 1 or Major Incidents, establish and provide timely updates to the stakeholders as well as coordinate efforts between resources/teams to bring the systems back to operational capacity. Create and distribute After Action Review to department leadership, executive m

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Full-time, Contract

Senior IT Audit Professional

Remote

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Today

Become a part of our caring community and help us put health first The Senior IT Audit Professional develops, plans and evaluates internal audit programs for us's information systems and related procedures to ensure compliance with our policies, procedures and standards. The Senior IT Audit Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. You will report to Manager, IT Internal

Full-time

USD 94,900.00 - 130,500.00 per year

Burgess Source Configurator - Medicaid (Remote)

Remote

•

Yesterday

Burgess Source Configurator - Medicaid Location: Remote About Us: Known for Delighting the Client through performance, innovation, and an employee-centric culture, S2Tech is a fast-growing IT consulting company serving clients in over a quarter of the United States. We are widely recognized as a leading provider of both technical and business services in support of Health and Human Services-related projects. Why S2Tech?: Stable, privately-owned company with a strong reputation for building long-

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Full-time

Depends on Experience

Sr. Organizational Change Manager

Remote or Hybrid in Baltimore, Maryland

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17d ago

Project Overview The Sr. Organizational Change Manager will focus on leading the change management activities within a structured process framework, including changes to business processes, systems, and technologies. Designing the strategic approach to managing change and support operations that fall within the domain of change management. Create and deliver strategies and plans to help employees maximize the adoption of new programs by honing methods of effective and sustainable behavior change

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Contract

Depends on Experience

Data Engineering Lead

Remote

•

Today

Type of Requisition: Regular Clearance Level Must Currently Possess: None Clearance Level Must Be Able to Obtain: None Public Trust/Other Required: MBI (T2) Job Family: Data Science and Data Engineering Job Qualifications: Skills: AWS Cloud Operations, Cloud Infrastructure, ETL, Medicaid, Medicare Claims Certifications: None Experience: 10 + years of related experience ship Required: No Job Description: DATA ENGINEERING LEAD Own your opportunity to turn data into measurable outcomes for

Full-time

USD 170,000.00 - 230,000.00 per year

Defect Management Testing Manager (healthcare / Medicare / Medicaid systems)

Remote

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3d ago

We are seeking to hire a Defect Testing Manager to join our team working on a new multi-year award we have within a State Govt client, updating their Medicare/Medicaid systems. This role is 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 Federal Holidays, and a matching 401k). An option for working on an hourly rate is als

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Full-time

Depends on Experience

Lead Machine Learning Engineer - Next Best Action (NBA) Platform

Remote

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Today

Become a part of our caring community and help us put health first We are seeking a Lead Machine Learning Engineer to architect, develop, and manage machine learning systems that enable real-time, personalized decision-making across digital and assisted channels. These platforms leverage predictive modeling, optimization algorithms, and contextual data to identify the most relevant next action for each individual-at scale, with minimal latency, and with a strong emphasis on reliability and expla

Full-time

USD 129,300.00 - 177,800.00 per year

OnBase Developer (Remote)

Remote

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9d ago

OnBase Developer Location: Remote U.S. About Us: Known for Delighting the Client through performance, innovation, and an employee-centric culture, S2Tech is a fast-growing IT consulting company serving clients in over a quarter of the United States. We are widely recognized as a leading provider of both technical and business services in support of Health and Human Services-related projects. Why S2Tech?: Stable, privately-owned company with a strong reputation for building long-term client rela

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Full-time

Depends on Experience

Professional Field Representative - Remote Wisconsin

Remote or Milwaukee, Wisconsin

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Today

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development. Summary The Professional Field Representative plays a key role in supporting Wisconsin Medicaid providers by partnering to resolve comp

Full-time

USD 54,300.00 - 77,500.00 per year

Aetna Technology Medicaid Director Product Portfolio

Remote or Downers Grove, Illinois

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Today

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health , you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. Position Summary CVS Health is embarking on a bold digi

Full-time

USD 144,200.00 - 288,400.00 per year

Principal Cloud Developer with Jira Experience

Remote

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Today

Type of Requisition: Regular Clearance Level Must Currently Possess: None Clearance Level Must Be Able to Obtain: None Public Trust/Other Required: BI Full 6C (T4) Job Family: Software Engineering Job Qualifications: Skills: Atlassian, Atlassian JIRA, AWS Cloud Computing Certifications: None Experience: 5 + years of related experience ship Required: No Job Description: Transform technology into opportunity as a Principal Cloud Developer at GDIT. Shape what's next for mission-critical gov

Full-time

USD 129,200.00 - 174,800.00 per year

Service Level Agreement Analyst (Remote in USA)

Remote or Birmingham, Alabama

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Today

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development. Summary The Service Level Agreement (SLA) Analyst is responsible for overseeing the development, implementation, monitoring, and manage

Full-time

USD 64,500.00 - 92,200.00 per year

Professional Trainer/Instructional Designer (Remote in USA)

Remote or Oklahoma City, Oklahoma

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Today

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development. Summary We're seeking a highly skilled Instructional Designer who thrives both independently and in collaborative environments. The ide

Full-time

USD 51,700.00 - 73,800.00 per year

Technology Lead

Remote

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Today

Become a part of our caring community and help us put health first The Lead, Technology Solutions devises an effective strategy for executing and delivering on IT business initiatives. The Lead, Technology Solutions works on problems of diverse scope and complexity ranging from moderate to substantial. Exercises independent judgment and decision making on solving complex technical problems and related tasks and works under minimal supervision. This role requires someone with hands on experience

Full-time

USD 117,600.00 - 161,700.00 per year

Senior Manager, Data Analytics - Optum State Government - Remote

Remote or Belleville, Illinois

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Today

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together. Optum State Government

Full-time

USD 112,700.00 - 193,200.00 per year

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