Medicaid Eligibility SME Job at NTT DATA (Nashville)

Job Description

This Medicaid Eligibility Subject Matter Expert (SME) will be a valued member of the client’s Business Services Support team. He/she will work directly with the client’s operations staff to assist with ongoing system enhancement work. This includes but is not limited to participation in definition, design, testing and implementation of changes in each of the system releases. The Medicaid Eligibility SME will work collaboratively with the client and other vendors on the client’s projects and initiatives. He/she will provide valuable business analysis services and subject matter expertise through consultation with the client. The Medicaid Eligibility SME will integrate seamlessly with the client team to ensure that business needs are met by managing and driving change using knowledge and experience.

Job Responsibility

Work collaboratively with the Member Services team leveraging their Eligibility business operations skills and expertise as well as their systems implementation experience, to improve the operational efficiency of the team and increase the quality of the systems enhancements and changes that go into production
Work collaboratively with the Member Services Partner Support team supporting onboarding and administrative tasks, including trouble shooting and problem solving
Support Member Services Member communication team with daily notice review, researching notice issues, review of data fixes and notice User Acceptance Testing
Participate in identifying any operational impacts created by proposed system changes and recommend modifications to business workflow and processes
Participate in requirements definition and design, business workflow development, design, and improvement, the review of system integration test case and results, and the review of user acceptance test case and results
Participate in implementation planning and execution activities, such as operational readiness tests, parallel tests, and beta tests
Develop and execute Eligibility Business Operations Test Cases as part of the User Acceptance phase for each system release
Collaborate with the Enterprise Testing Management Office (eTMO) to ensure that testing standards and processes are maintained as the Eligibility Business Operations Test Cases are executed and defects are identified
Employee is expected to undertake any additional duties as they are assigned by their manager

Requirements

Bachelor’s degree or equivalent experience
A minimum of 6 years’ experience in the health and human services eligibility determination
A minimum of 1 years’ experience interpreting complex eligibility determination rules, policy, and processes
A minimum of 3 years’ experience conducting meetings and making presentations
A minimum of 3 years’ business experience working on large complex system implementation and/or enhancement projects
A minimum of 1 year experience interacting with vendors and third parties effectively to meet commitments and milestones
A minimum of 1 year testing experience
Must be able to travel to Nashville, Tennessee, as requested

Nice to have

Ability to work independently and manage work to a defined schedule
Strong written and verbal communication skills
Strong problem-solving and customer service skills
Team player and a consistent, dependable performer with an excellent work ethic, flexible “can-do” attitude, and a results-driven commitment to success
Ability to apply industry best practices and future state/federal mandates to existing systems
Excels at using quantitative data to drive recommendations and decisions

What we offer

medical, dental, and vision insurance with an employer contribution
flexible spending or health savings account
life and AD&D insurance
short and long term disability coverage
paid time off
employee assistance
participation in a 401k program with company match
additional voluntary or legally-required benefits

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Medicaid Eligibility SME

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