MMIS (Medicaid) Project/Functional Consultant

3 weeks ago


Cranston, Rhode Island, United States North Highland Full time

REACH YOUR POTENTIAL | COLLABORATE WITH AMAZING PEOPLE | MAKE CHANGE HAPPEN

Do you have the skills, passion, and commitment to transform our clients for the better? Are you ready to be a changemaker? If so, join us.

North Highland is the world's leading change and transformation consultancy. Simply put, we make change happen like no one else. And we're on the hunt for a new MMIS Project/Functional Consultant.

HOW WILL YOU MAKE CHANGE HAPPEN?

The Medicaid Management Information System (MMIS) core is used to process claims for Medicaid payment to Providers of medical care and services furnished to recipients under the Medicaid program. The STRI Medicaid Management Information System core currently performs functions necessary for the management, monitoring, fiscal operations and administration of the Medicaid program.



YOU WILL HAVE:

  • In-depth knowledge of the Medicaid Management Information System (MMIS) core functions, including processing claims and encounters for Medicaid payment to providers.
  • Proficiency in Electronic Data Interchange (EDI) for efficient and accurate data transmission.
  • Experience with financial operations within MMIS, including managing and processing capitation payments.
  • Familiarity with claims adjudication processes and the ability to manage claims-related workflows effectively.



IDEALLY, WE'D LIKE:

  • Expertise in Provider Management solutions to enhance the efficiency of services rendered to the Medicaid community.
  • Experience with consolidating Medicaid licensure and enrolment processes through a centralized portal.
  • Ability to automate update capabilities for provider information, such as address changes.
  • Proficiency in workflow assignment, application tracking, and provider interaction management.
  • Strong analytical and problem-solving skills to address project challenges.
  • Excellent communication and collaboration abilities to work effectively with various stakeholders.
  • Knowledge of Medicaid policies and regulations to ensure compliance and alignment with project goals.
  • Ability to contribute to the development of project charters, business process workshops, and cost-benefit analyses.

ADDITIONAL INFORMATION:

The candidate should also be able to demonstrate a track record of successful project management and delivery within the Medicaid program context. They should be comfortable working in a dynamic environment, adapting to evolving project requirements, and contributing to the project's strategic vision.

Location: Remote or New York

Hourly Rate: $120-130

Start Date: ASAP

Duration: 4 months

TRANSFORMING CLIENTS. TRANSFORMING CAREERS.

Success—for both our clients and our colleagues—is all about putting people first and doing great things together. We believe that when we work as one team, we can take action today to build lasting capability for tomorrow.

We strive to have the most enviable culture on the planet, inspiring people to reach their full potential. Here's how we make it happen:

Intentional, flexible growth. We never want you to settle. Leading your own growth and transformation is your prerogative—one which we'll help you nurture and develop every step of the way. We'll inspire you to learn, teach, and ultimately carve your own path. That means you grow, we grow, and so do our clients.

People-first, and then some. It goes without saying that people come first, but what comes next? Our people are always at the heart; your wellbeing and success is built on a collective understanding that every one of us can be a coach, a friend, and a fantastic listener—regardless of job title. We think of it as a celebration of individuality, difference, and diversity.

Make your own change happen. With us, your curiosity and creativity know no bounds. The reins are off. All we ask is that you have the courage to transform yourself and those around you—colleagues and clients alike. If you've got the drive to become a changemaker, we'll do the rest.

Enviable Total Rewards. We inspire our employees to do their best work. North Highland's Total Rewards Program encompasses PTO, Medical, Dental, Vision, STD/LTD, Life Insurance, FSA/HSA, 401(k), and a variety of other perks like a dedicated Health Advocate, commuter benefits, and legal assistance. In addition, a competitive hourly rate of: $120- $130.

READY TO MAKE CHANGE HAPPEN?

North Highland makes change happen, helping businesses transform by placing people at the heart of every decision. It's how lasting progress is made. With our blend of workforce, customer, and operational expertise, we're recognized as the world's leading transformation consultancy. We break new ground today, so tomorrow is easier to navigate.

Founded in 1992, North Highland is regularly named one of the best places to work. We are a proud member of Cordence Worldwide, a global network of truly connected consultancy firms with the ability to think and deliver together.

This means North Highland has more than 3,500 experts in 50+ offices around the globe on hand to partner with you.

Please note that applicants must be authorized to work in the United States without the need for visa sponsorship by North Highland. Work visa sponsorship will not be provided, either now or in the future, for this position.

North Highland is an Equal Employment Opportunity (EEO)/Affirmative Action employer. All qualified applicants will receive fair and impartial consideration without regard to race, color, sex, gender identity, religion, national origin, age, sexual orientation, disability, veteran status, or any other characteristic protected by law.


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