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Medicaid Subject Matter Expert
3 months ago
Key Responsibilities:· Expert Consultation: Provide expert guidance and insights on Medicaid policies, regulations, and best practices to inform the design and implementation of case management solutions.· Solution Development: Collaborate with product development teams to ensure that the case management solution meets the specific needs and requirements of Medicaid programs.· Process Optimization: Identify opportunities to enhance the efficiency and effectiveness of case management processes within Medicaid programs.· Stakeholder Engagement: Work closely with internal and external stakeholders, including healthcare providers, government agencies, and other relevant organizations, to ensure alignment and compliance with Medicaid standards.· Training and Support: Develop and deliver training programs for internal teams and end-users to ensure proper understanding and utilization of the case management solution.· Compliance Monitoring: Stay current with changes in Medicaid regulations and ensure that the case management solution remains compliant with all relevant laws and guidelines.· Documentation: Create and maintain comprehensive documentation on Medicaid requirements, processes, and best practices as they relate to case management.
Qualifications:· Education: Bachelor’s degree in Healthcare Administration, Public Health, Social Work, or a related field. Master’s degree preferred.· Experience: Minimum of 5 years of experience working with Medicaid programs, including in-depth knowledge of Medicaid policies, regulations, and case management practices.· Expertise: Strong understanding of Medicaid case management processes, including eligibility, enrollment, care coordination, and utilization management.· Skills:o Excellent analytical and problem-solving skills.o Strong communication and interpersonal abilities.o Ability to work collaboratively with cross-functional teams.o Proficiency in using case management software and tools.
· Certifications: Relevant certifications in Medicaid, healthcare management, or case management are a plus.
