Analyst Medicaid Modernization (Enrollments)

Functional Consultant to support the Enrollment track of a NY State Medicaid Eligibility Project M&O team with a focus on Enrollment domain production support defect triage operational enhancements and release readiness. The role focuses on requirements analysis incident investigation solution articulation stakeholder coordination and HIPAA transaction support including 834 EDI.

Key requirements:

• 4 7 years of experience as a Business / Functional Consultant in healthcare and/or public sector programs
• Strong Medicaid eligibility policy knowledge including enrollment and managed care
• Hands-on experience with HIPAA 834 or 837 transactions including segments loops code sets and companion guides
• Experience with NY eMedNY (or any other MMIS) and related inbound/outbound transaction interchange
• Ability to analyze and maintain requirements production issues enhancement requests process flows data mappings interface specifications and operational procedures
• Strong client-facing communication skills; able to work with State MCO and vendor stakeholders
• Experience supporting incident management defect triage root cause analysis testing coordination and release validation
• Proficiency with JIRA Confluence Visio and MS Office

Preferred:

• Experience supporting HIPAA 834 EDI 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