Implementation/Integration Consultant (Medicaid Systems) (hybrid)

Vitaver & Associates • Pierre, SD

4d • Hybrid

About The Position

This is a temporary project role for an Implementation/Integration Consultant specializing in Medicaid Systems. The project is estimated to last 12+ months with possible extensions. The work setting is hybrid, with 25% onsite and 75% remote. Candidates must be able to relocate as required to be considered for future opportunities.

Requirements

• Experience with CMS Interoperability and Patient Access Final Rule (CMS-9115-F) and CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F) compliance implementation
• Experience with FHIR APIs, including cloud-hosted FHIR API servers supporting FHIR version 4.0.1 or greater
• Experience with SMART on FHIR authorization and application framework (OAuth 2+, OpenID Connect 1+)
• Experience with FHIR implementation guides including CARIN IG for Blue Button, US Core IG, and Da Vinci IG
• Experience with Patient Access API, Provider Access API, and Payer-to-Payer API implementation
• Experience with health plan data including claims, encounters, clinical data (USCDI v1+), and drug formulary data
• Experience with identity verification, consent management, and member authentication systems
• Experience with Medicaid, Medicare Advantage, or Federally Facilitated Exchange health plan systems
• Experience with third-party API developer portals, sandbox environments, and third-party application security risk assessments
• Experience with requirements traceability matrices (RTM) and formal project implementation methodologies
• Experience with state government or Medicaid Management Information Systems (MMIS) integration

Responsibilities

• Implement and support Patient Access API, Provider Access API, and Payer-to-Payer API solutions compliant with CMS-9115-F and CMS-0057-F requirements
• Configure and maintain cloud-hosted FHIR API infrastructure including façade data models, data maintenance timeframes, and 99.9% system availability standards
• Implement consent and identity management system including SMART on FHIR authorization, OAuth 2+/OpenID Connect integration, and member consent tracking
• Manage third-party application registration, onboarding, attestation, security risk assessment, and developer support portal
• Develop and execute project plan, requirements documentation, test plans, and system/integration testing including user acceptance testing prior to go-live
• Provide ongoing system maintenance, incident and error reporting, software improvements for regulatory compliance, and technical support
• Deliver training and self-service training materials for staff during implementation and on an ongoing basis as new features are released

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed