Technology Solutions Management Consultant

Conduent

5h • $101,063 - $130,000

About The Position

We are seeking an experienced Technology Solutions Management Consultant with deep expertise in Medicaid claims processing, encounter data, and related healthcare IT systems. The ideal candidate will bring strong knowledge of Medicaid regulations, EDI transactions, and MMIS platforms, while collaborating cross-functionally to ensure compliance and system accuracy.

Requirements

• Bachelor’s degree in healthcare administration, Information Systems, or a related field (Master’s preferred).
• 5+ years of experience in Medicaid claims processing or healthcare IT systems.
• Strong understanding of Medicaid regulations, policies, and managed care programs.
• Proficiency with Medicaid Management Information Systems (MMIS) and encounter data systems.
• Experience with claims adjudication systems and Electronic Data Interchange (EDI).
• Familiarity with CMS guidelines and state-specific Medicaid programs.
• Strong analytical, problem-solving, and communication skills.
• Ability to work independently and manage multiple priorities in a fast-paced environment.

Nice To Haves

• Experience working in Agile or Scrum environments.
• Knowledge of data analytics tools such as SQL and Tableau.
• Prior experience supporting state Medicaid agencies or CMS contractors.

Responsibilities

• Serve as the Subject Matter Expert (SME) for Medicaid claims processing and encounter data systems.
• Provide expert-level knowledge of the Medicaid claims life cycle, including HIPAA X12 transactions (837, 835) and NCPDP formats.
• Collaborate with cross-functional teams (IT, QA, Business Analysts) to ensure accurate implementation of Medicaid requirements.
• Analyze and interpret Medicaid policy changes and translate them into detailed system requirements.
• Support testing, validation, and quality assurance of Medicaid claims software applications.
• Develop and maintain documentation, training materials, and process workflows.
• Participate in audits, compliance reviews, and quality assurance initiatives.
• Provide mentorship and guidance to junior team members and stakeholders.

Benefits

• health insurance coverage
• voluntary dental and vision programs
• life and disability insurance
• a retirement savings plan
• paid holidays
• paid time off (PTO) or vacation and/or sick time

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level