Analyst - Medicaid Modernization (Enrollments)
Not Disclosed•ContractorOn-site
location_on21, Mount Hope Drive, Mount Hope, City of Albany, Albany County, New York, 12202, United States
About the Role
This position serves as a Functional Consultant dedicated to the Enrollment track of a New York State Medicaid Eligibility Project Management & Operations (M&O) team. The primary mission is to ensure the stability and efficiency of the Enrollment domain through robust production support, strategic defect triage, and the execution of operational enhancements. The role acts as a critical bridge between technical execution and policy requirements, ensuring release readiness for critical healthcare systems.
In this capacity, you will engage in deep requirements analysis and incident investigation to articulate effective solutions. A significant portion of the work involves coordinating with diverse stakeholders to navigate the complexities of HIPAA transaction support, specifically focusing on 834 EDI standards. The role demands a nuanced understanding of Medicaid eligibility policies, particularly regarding enrollment and managed care, to effectively maintain production issues and process flows.
Hiring Process
Candidates selected for this opportunity will undergo a structured evaluation designed to assess both technical proficiency in healthcare systems and the ability to communicate effectively with state and vendor partners. The process typically includes an initial screening to verify experience with NY eMedNY or similar MMIS platforms, followed by a technical discussion focused on HIPAA transaction logic and defect triage methodologies. Final stages involve stakeholder interviews to evaluate client-facing communication skills and cultural fit within the M&O team.
Equal Opportunity Employer
We are committed to building a diverse and inclusive workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
Work location
Work model: On-site
21, Mount Hope Drive, Mount Hope, City of Albany, Albany County, New York, 12202, United States
City of Albany, New York
Key Responsibilities
- check_circleSupport the Enrollment track of the NY State Medicaid Eligibility Project M&O team
- check_circleProvide HIPAA 834 EDI transaction support and analysis
- check_circleAnalyze and maintain process flows, data mappings, and interface specifications
- check_circlePerform incident investigation, defect triage, and root cause analysis
- check_circleConduct requirements analysis and solution articulation for enrollment domain issues
- check_circleManage stakeholder coordination with State, MCO, and vendor teams
- check_circleCoordinate operational enhancements and release readiness activities
- check_circleCoordinate testing activities and release validation efforts
Requirements
- verified4-7 years experience as Business/Functional Consultant in healthcare or public sector
- verifiedStrong Medicaid eligibility policy knowledge
- verifiedHands-on experience with HIPAA 834 or 837 transactions
- verifiedExperience with NY eMedNY or MMIS
- verifiedProficiency with JIRA, Confluence, Visio, and MS Office
Nice to Have
Experience supporting HIPAA 834 EDI transactions. 3+ years supporting Enrollment on a Medicaid platform. Work experience with eMedNY. Familiarity with Managed Long Term Care enrollment concepts and non-MAGI workflows. SQL/basic data analysis for reconciliation and defect investigation.
Similar Job Opportunities
Frequently asked questions about Analyst - Medicaid Modernization (Enrollments) at CAYS Inc.
What does a Analyst - Medicaid Modernization (Enrollments) at CAYS Inc. do?expand_more
Day-to-day, the Analyst - Medicaid Modernization (Enrollments) at CAYS Inc. will support the enrollment track of the ny state medicaid eligibility project m&o team; provide hipaa 834 edi transaction support and analysis; analyze and maintain process flows, data mappings, and interface specifications; and perform incident investigation, defect triage, and root cause analysis.
What are the requirements for this Analyst - Medicaid Modernization (Enrollments) role?expand_more
CAYS Inc. is looking for candidates who meet the following requirements: 4-7 years experience as Business/Functional Consultant in healthcare or public sector; Strong Medicaid eligibility policy knowledge; Hands-on experience with HIPAA 834 or 837 transactions; Experience with NY eMedNY or MMIS; and Proficiency with JIRA, Confluence, Visio, and MS Office.
Where is the Analyst - Medicaid Modernization (Enrollments) role at CAYS Inc. located?expand_more
Analyst - Medicaid Modernization (Enrollments) at CAYS Inc. is based in 21, Mount Hope Drive, Mount Hope, City of Albany, Albany County, New York, 12202, United States. This is a on-site role.
Is this Analyst - Medicaid Modernization (Enrollments) job remote, hybrid, or on-site?expand_more
CAYS Inc. has listed this Analyst - Medicaid Modernization (Enrollments) role as on-site.
How much experience is required for this Analyst - Medicaid Modernization (Enrollments) role?expand_more
Analyst - Medicaid Modernization (Enrollments) at CAYS Inc. typically requires 4–7 years of relevant experience at the mid level level.
What skills do you need for the Analyst - Medicaid Modernization (Enrollments) role at CAYS Inc.?expand_more
Key skills for Analyst - Medicaid Modernization (Enrollments) at CAYS Inc. include Hipaa; 834 Ed; 837 Transactions; Emedny; Mmis; Jira; Confluence; and Visio.
What category does the Analyst - Medicaid Modernization (Enrollments) role belong to?expand_more
Analyst - Medicaid Modernization (Enrollments) at CAYS Inc. is part of the it job category on Recrutus.
About CAYS Inc.
CAYS Inc. operates within the staffing and recruiting industry, with its headquarters located in El Segundo, California. This global Information Technology firm delivers a comprehensive portfolio of IT and consulting services tailored for Fortune 500 companies. By managing these specialized functions, CAYS enables client organizations to concentrate on their core business operations while achieving significant cost savings through high-quality service delivery.
The company's operational philosophy centers on a people-centric approach, emphasizing collaboration between its workforce and its diverse client base. CAYS addresses immediate challenges while anticipating future needs, utilizing advanced technology and a skilled workforce to provide effective solutions. This strategy ensures that clients receive timely support and strategic leverage.
A key aspect of the organization involves fostering a multicultural work environment where employees from various backgrounds collaborate. This inclusive approach aims to create a sustainable and healthy workplace culture designed to retain exceptional talent. Through these combined efforts, CAYS Inc. maintains a reputation for delivering value to major enterprise clients through strategic staffing and technological expertise.
Browse more roles: All CAYS Inc. jobs, it jobs on Recrutus.