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The candidate will manage the configuration and maintenance of Medicaid benefit plans, provider contracts, and reference tables. They will also be responsible for troubleshooting and providing production support for claims adjudication components.
Seeking a highly skilled Reference SME with strong expertise in Medicaid Reference Configuration, BPA setup, Oracle, C, and Pro*C technologies. The candidate will manage configuration and maintenance of Benefit Plans, Assignment Plans, Provider Contracts, Reference Tables, Rule Metadata, and BPA configuration components used in claims adjudication.The role requires deep understanding of Medicaid reference data structures and how reference configuration impacts claims, provider enrollment, reimbursement, audits, and policy administration.
Required Technical Skills
Programming Skills
Reference/BPA Skills
Ideal Candidate Profile
Reference SME (9+ Years)
60% Technical | 40% Functional
Remote Opportunities
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