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Gainwell Technologies LLC

Medicaid BPA Configuration

Posted an hour ago
10+ years experience
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AI Summary

The candidate will manage the configuration and maintenance of benefit plans, provider contracts, and reference tables for Medicaid claims adjudication. They will also be responsible for rule metadata management and ensuring configuration governance.

Summary

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.

 

Your role in our mission

Required Technical Skills

Programming Skills

  • C Programming
  • Pro*C
  • Oracle SQL
  • PL/SQL
  • Unix/Linux Shell Scripting
  • Batch Processing

Reference/BPA Skills

  • BPA Configuration
  • Reference Data Management
  • Rule Metadata
  • Rule Variables
  • Benefit Classifications
  • Rule Sheets
  • Release Management
  • Provider Contracts
  • Benefit Plan Hierarchies
  • Assignment Plan Hierarchies

What we're looking for

Ideal Candidate Profile

Reference SME (9+ Years)

60% Technical | 40% Functional

  •  
    • Strong Oracle, C, Pro*C expertise
    • Deep BPA configuration knowledge
    • Provider Contract and Benefit Plan maintenance experience
    • Rule Metadata and Rule Sheet management
    • Configuration governance and release management expertise
    • Strong troubleshooting and production support capability

What you should expect in this role

  • Remote Opportunities 

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