Estimated Length: 24 months Full-Time Negotiable Hours

Mandatory Requirements

Senior 60 - 84 Months

Desired Requirements

• Bachelor’s degree in a Technical field.
• At least 60 months of experience with the Title XIX New York State Medicaid Program. 
• At least 60 months of experience with large-scale MMIS  such as eMedNY, or Healthcare systems..
• At least 48 months of experience in a Medicaid environment with  the interactions between Medicaid, Medicaid Managed Care, Medicare, providers and other state and federal agencies and programs.
• At least 48 months of experience Medicaid Claims Processing.
• At least 48 months of experience Medicaid Finance, Provider, Client or Third Party Liability.
• At least 48 months of experience with developing and maintaining working relationships with local districts, the Medicaid provider community, other bureaus within the client agency, other departments or federal agencies. 
• At least 48 months of experience working directly with PHI and PII daily in a HIPAA covered environment.

Responsibilities

• Work collaboratively to identify and resolve Claims and Financial, Provider, Client or Third Party Liability Subsystem problems and issues to assure that ongoing eMedNY operations are performing efficiently; 
• Provide SME support as needed for eMedNY Claims and Financial, Provider, Client or Third Party Liability evolution initiatives;
• Analyze and evaluate Claims and Financial Subsystem processes and interfaces including identification of impacts and appropriate remediation enhancements;
• Report and provide support to eMedNY management on claims and financial issues; and, as directed, collaborate in and support the design, development and implementation of activities necessary to maintain client support functions with other state agencies, other federal agencies and the provider community;
• Work collaboratively to interpret Medicaid policy vis-à-vis systems functionality, and participate in the development of the client's Medicaid initiatives;
• Represent the client and eMedNY at seminars and training sessions as needed.

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