Very Urgent:Requirement: Medicaid Business SME - 12+ Months Contract - Springfield, IL

Hi,

 

Please see the requirement and share your consultant profile at shweta.singh@ustechsolutionsinc.com

 

Requirement:

Position: Medicaid Business SME

Location: Springfield, IL

Type: 12+ Months Contract

 

 

Job Description

Client requires a Medicaid subject matter expert (SME) with experience in managed care business practice for managing the monitoring of the Department's managed care program.  The SME will provide business expertise to the project as required by the client. The SME will be responsible for understanding the business rules and related legacy systems that support the current MMIS managed care processes.  The SME will participate in requirements analysis and quality assurance testing. The SME will be required to document defects in quality assurance testing, and may be required to review requirements documentation to determine accuracy of the intended solution

Skill set requirement

1)    7-10  year experience in Healthcare industry with extensive knowledge on MCO processing

2)    5+ years of experience working with managed care business practices, either in Medicaid, Medicare or in the private sector

3)    4+ years of experience analyzing data, preferably related to health care coordination, utilization management, health outcomes, grievance and appeals to determine compliance with requirements

4)    Experience or ability to learn Share Point

5)    3+ years of experience with analysis/development of healthcare EDI files and familiarity with any database tools (ex: SQL)

6)    2+ Experience producing professional business documentation, Ability to facilitate business requirements and discussions with client staff on business and functional topics

7)    Analyze current business processes, suggest improvements, and participate in design of new functionality

8)    Create functional designs and produce business process documents for claim processing, reports, and configurations, such as workflow and/or rule

9)    Excellent written and oral communication skills

10) Experience in MS-word/excel/PowerPoint

11)Exposure/Experience managing programming languages, i.e. COBOL in mainframe environment.

 

 

Thanks & Regards
 
Shweta Singh
Technical Recruiter

201-549-2745 - Direct
201-524-9600 ext 7709- Work
201-221-8582- eFax 
E-mail: shweta.singh@ustechsolutionsinc.com 
US Tech Solutions Inc. www.ustechsolutions.com

10 Exchange Place, Suite #1820, 18th floor, Jersey City, NJ 07302
Minority Certified/ Microsoft Gold Certified Partner

(US Tech is an Equal Opportunity Employer)

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