Techno Functional SME - Medicaid

SRM Technologies • Hamilton Township, NJ

2d

About The Position

We are looking for a highly experienced Senior Techno-Functional Subject Matter Expert (SME) with 12+ years of experience in Medicaid systems, Medicaid claims processing and regulatory compliance. Model N Flex/ PbyN experience remains highly desirable along with SQL, PL/SQL and Cognos expertise. This position plays a critical role in bridging business needs and technology, driving product implementations, integrations, and process transformations using platforms such as Model N, Revitas and modern cloud-based solutions.

Requirements

• 12+ years of experience in Medicaid systems, Medicaid claims processing and regulatory compliance.
• Model N Flex/ PbyN experience
• SQL expertise
• PL/SQL expertise
• Cognos expertise
• Deep expertise in Medicaid rebates and CLD
• Deep expertise in Government Pricing and Compliance
• Deep expertise in Pricing & Market Access
• Strong understanding of pharmaceutical commercial and regulatory landscapes
• Hands-on experience with Model N (mandatory)
• Hands-on experience with Revitas
• Strong data skills: SQL / PL-SQL
• Strong data skills: Informatica / ETL tools
• Strong data skills: UNIX
• Experience working with Cloud platforms (AWS/Azure)
• Requirement gathering and stakeholder management
• Gap analysis and solution design
• System configuration and implementation
• Testing (SIT, UAT) and validation
• Strong documentation and process modeling skills

Nice To Haves

• Model N Flex/ PbyN experience remains highly desirable

Responsibilities

• Lead end-to-end requirement gathering and stakeholder workshops across Commercial contracting and revenue management.
• Translate business needs into: Functional Requirements specification(FRS), Technical Design specification (TDS)
• Perform gap analysis and recommend optimized solutions aligned with business goals
• Partner with leadership to align strategic initiatives with IT transformation roadmap
• Act as Techno-functional SME for: Medicaid Rebates & Medicaid Claim Level detail (CLD) (primary), Government Pricing (secondary)
• Drive implementation and configuration of: Model N Flex (primary), ModelN PbYN
• Lead integration design across: ERP systems, Data warehouses, Upstream/downstream pricing systems
• Ensure scalable, cloud-enabled architecture for Medicaid rebate solutions
• Perform data analysis and validation using SQL / PL-SQL / Informatica
• Conduct financial impact assessments for pricing and contracting changes
• Identify trends, risks, and revenue leakage opportunities
• Support data-driven decision-making with actionable insights
• Lead System Integration Testing (SIT) and User Acceptance Testing (UAT)
• Act as a bridge between business stakeholders and IT teams
• Collaborate with cross-functional teams: Market Access, Finance, Compliance, IT / Engineering
• Facilitate workshops to define business use cases and future-state processes
• Drive adoption of emerging technologies such as: Cloud-based platforms
• Identify opportunities for: Operational efficiency, Cost optimization, Process automation

Benefits

• You will join a mission-critical team where your work directly impacts profit margins and ensures compliance in a rapidly evolving regulatory environment.
• You'll have the autonomy to drive innovation and the tools to make a measurable difference in protecting the organization’s revenue integrity.

What This Job Offers

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