Medicaid Financial and MES implementation Technical Lead

Agency

Dept of Health and Human Services

Division

SEC OFFICE - INFO TECH

Job Classification Title

Applications Systems Specialist I (NS)

Position Number

Grade

DT10

About Us

The North Carolina Department of Health and Human Services (DHHS) is one of the largest most complex agencies in the state and has approximately 17000 employees. It is responsible for ensuring the health safety and well-being of all North Carolinians providing human service needs for special populations including individuals who are deaf blind developmentally disabled and mentally ill and helping poor North Carolinians achieve economic independence.

Description of Work

We are seeking a highly experienced and technically proficient MES Implementation Technical Lead to join our team at Health & Human Services. This role will be instrumental in guiding the technical aspects of our Medicaid Enterprise System (MES) implementations focusing specifically on Medicaid Claims and Encounters modules and their integration ensuring compliance with federal and state regulations and driving successful project outcomes.

Primary Purpose of the Position

The primary purpose of this position is to work with the different Medicaid Enterprise System modules and Division multi-payers (NCTracks and EPS) on process improvements implementing new requirements and analyzing current production results. This position will serve as a liaison between the Division business owners and the vendor IT to improve productivity.
This position must be able to analyze forecast and trend complex addition it will present the analysis and interpretation for operational business review. This position must support short and long term operational/strategic business activities by recommending business process solutions through research and analysis of data. This resource will be responsible for verifying validating overseeing and maintaining technical application solutions for Tribal Care and Managed Care Claims and Encounter transactions in EPS and NCTracks multi-payer projects. Interaction with a broad range of clients and/or technology needed to support employees and requires strong communications skills and ability to use a wide range of technical resources for providing technical support. Position will work with internal staff external vendors and state level services. This position will provide advanced level support for a broad range of technologies.

Job Responsibilities*** Lead the technical design development and implementation of Medicaid financial modules within the MES including claims processing encounter data provider payments and financial reporting.* Provide expert technical guidance and oversight to development teams ensuring adherence to architectural standards best practices and security protocols.* Collaborate with business stakeholders program managers and vendors to translate complex business requirements into robust and scalable technical solutions.* Oversee the integration of the MES financial components with other state systems third-party applications and federal reporting interfaces.* Conduct technical reviews of system designs code and test plans to ensure quality performance and maintainability.* Troubleshoot and resolve complex technical issues related to Medicaid financial processes and MES functionality.* Develop and maintain comprehensive technical documentation including architecture diagrams design specifications and operational procedures.* Stay abreast of federal and state Medicaid regulations industry standards and emerging technologies to ensure MES compliance and optimization.* Mentor and provide technical leadership to junior team members.

Knowledge Skills and Abilities/Management Preferences

Candidates now meet the minimum qualifications of a position if they meet the minimum education and experience listed on the vacancy announcement.

The Knowledge Skills and Abilities (KSAs)/ Management Preferences are not required. Applicants who possess the following skills are preferred:

• Progressive experience in IT specifically focused on Medicaid Claims Encounters financial systems and MES implementations and understanding of Medicaid program regulations (e.g. CMS 7 Standards and ConditionsT-MSIS) and financial operations.
• Proven experience leading technical teams in large-scale system integration and implementation projects.
• Excellent analytical problem-solving and communication skills with the ability to articulate complex technical concepts to non-technical audiences.
• Demonstrated ability to work effectively in a fast-paced collaborative environment and manage multiple priorities.

About the NCDHHS Information Technology Division:

In collaboration with our partners the North Carolina Department of Health and Human Services (DHHS) protects the health and safety of all North Carolinians and provides essential health and human services. The IT division (ITD) is one of the divisions that report to the Operational Excellence portfolio. The ITD division comprises four sections: Implementation and Operations Strategy and Workforce Enterprise Technology and Vendor and Finance. ITD offers the following services but not limited to implementations operations project/portfolio management infrastructure consulting business division liaison digital transformation IT

About the Office of the Secretary:

The Office of the Secretary serves as the executive leadership arm of the North Carolina Department of Health and Human Services (NCDHHS) guiding the Departments mission to improve the health safety and well-being of all North Carolinians. Through strategic oversight and collaborative leadership the Secretarys Office supports the effective coordination of over a dozen core divisions ensuring that agency-wide priorities are aligned resources are used responsibly and services are delivered with equity and impact.

Compensation and Benefits:

The State of North Carolina offers excellent comprehensive benefits. Employees can participate in health insurance options standard and supplemental retirement plans and the NCFlex program (numerous high-quality low-cost benefits on a pre-tax basis). Employees also receive paid vacation sick and community service addition paid parental leave is available to eligible employees. Visit the website forState Benefits.

Supplemental Contact Information

The North Carolina Department of Health and Human Services (DHHS) is an Equal Opportunity Employerthat embraces an Employment First philosophy which consists of complying with all federallaws state laws and Executive Orders. We are committed to reviewing requests for reasonable accommodation at any time during the hiring process or while on the job. For more information about DHHS: uses the Merit-Based Recruitment and Selection Plan to fill positions subject to the State Human Resources Act with the most qualified individuals. Hiring salary will be based on relevant qualifications internal equity and budgetary considerations pertinent to the advertised position.

In accordance with the Governors Executive Order 303 our agency supports second-chance employment for individuals who were previously incarcerated or justice-involved. We invite all potential applicants to apply for positions for which they may be qualified.

Application Process
Be sure to complete the application in its entirety. Resumes will not be accepted in lieu of completing this application.

• Information should be provided in the appropriate areas to include the following: Education including high school and all degrees obtained Work Experience and Certificates & Licenses. It is critical to our screening and salary determination process that applications contain comprehensive candidate information.
• Answers to Supplemental Questions are not a substitute for providing all relevant information within the body of your application. To receive credit for the supplemental questions you must provide supporting information within the Work Experience section of the application to support your answers.
• If multiple applications are submitted to an individual posting only the most recent application received prior to the closing date will be must be submitted by 11:59 PM on the closing date.
• Applicantsmaybe subject to a criminal background check. All candidates selected for positions considered Positions of Trustwill besubject to a criminal background check.
• Due to the volume of applications received we are unable to provide information regarding the status of your application over the phone. To check the status of your application please log in to your account. Upon the closing date applications are Under Review and will be screened by Human Resources for qualified applicants. The hiring process may take several weeks.
• Degrees must be received from appropriately accredited institutions. Transcripts and degree evaluations may be uploaded with your State of North Carolina/Office of State Human Resources uses the National Association of Credential Evaluation Services (NACES) as a referral resource for applicants who need to have their credentials certified as equivalent.
• For a list of organizations that perform this specialized service please visit the NACES membership website at Credit Verification

  Degrees must be received from appropriately accredited institutions. Transcripts degree evaluations and cover letters may be uploaded with your application.

  
  

  Veterans and National Guard Preference

  • Applicants seeking Veterans Preference must attach aDD-214 Member-4 Form(Certificate of Release or Discharge from Active Duty) to their applications.
  • Applicants seeking National Guard Preference must attach an NGB 23A (RPAS) along with the state application if they are a current member of the NC National Guard in good standing.
  • Applicants who are former members of either the NC Army National Guard or the NC Air National Guard with honorable discharge and six years of creditable service must attach a copy of the DD 256 or NGB 22 along with the state application.
  
  

  ADA Accommodations

  Consistent with the Americans with Disabilities Act (ADA) and the Pregnant Workers Fairness Act (PWFA) DHHS is committed to the full inclusion of all qualified individuals. As part of this commitment DHHS will ensure that people with disabilities or known limitations covered by the PWFA are provided with reasonable accommodation. If reasonable accommodation is needed to participate in the job application or interview process please contact the person indicated below.

  
  

  CONTACT INFORMATION:

  If there are any questions about this posting please contact Talent Acquisition. Resumes will not be accepted in lieu of completing this application.

  
  

  Minimum Education and Experience

  Some state job postings say you can qualify by an equivalent combination of education and experience. If that language appears below then you may qualify through EITHER years of education OR years of directly related experience OR a combination of both. See the Education and Experience Equivalency Guide for details.

  
  

  Bachelors degree in computer science or an IT related field or related technical degree from an appropriately accredited institution and four years of progressive experience in business application consulting or development

  OR

  Associate degree in computer science or an IT related field or related technical degree from an appropriately accredited institution and five years of progressive experience in business application consulting or development

  OR

  High School or General Education Development (GED) diploma and eight years of experience in business application consulting or development

  OR

  An equivalent combination of education and experience.

  EEO Statement

  The State of North Carolina is an Equal Employment Opportunity Employer and dedicated to providing employees with a work environment free from all forms of unlawful employment discrimination harassment or retaliation. The state provides reasonable accommodation to employees and applicants with disabilities; known limitations related to pregnancy childbirth or related medical conditions; and for religious beliefs observances and practices.

  Recruiter:

  Dreisa Yvonne Johnson
  

  Contact:

  DHHS Workday Support Form