MMIS Medicaid - Medicare Specialist Job at Apexon, Gardiner, ME

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  • Apexon
  • Gardiner, ME

Job Description

Company Description:

Apexon is a digital-first technology services firm backed by Goldman Sachs Asset Management and Everstone Capital. We specialize in accelerating business transformation and delivering human centric digital experiences. For over 17 years, Apexon has been meeting customers wherever they are in the digital lifecycle and helping them outperform their competition through speed and innovation.

Job Description:

  1. Independently assess and interpret MMIS-related technical documentation (e.g., system design documents, interface control documents, traceability matrices, configuration, etc.) ensuring completeness, consistency, alignment with Medicaid program needs, and appropriate linkage to design, development, testing, and deployment.
  2. Participate in MMIS system design reviews and technical discussions, offering insights grounded in deep knowledge of Medicaid systems and their implementation.
  3. Evaluate requirements traceability to ensure that functional and technical requirements are accurately captured and appropriately linked to design, development, testing, and deployment artifacts.
  4. Understand and explain Medicaid-specific system components, including where common gaps or risks may occur.
  5. Lead or contribute to the assessment of testing strategies and test artifacts, including user acceptance testing (UAT), end-to-end testing, and system integration testing, identifying coverage gaps and helping prioritize areas of concern.
  6. Support evaluation of data conversion and data migration efforts, including mapping, cleansing, and validation activities for modules such as provider, member, claims, and prior authorization.
  7. Translate complex technical information into actionable insights for a range of stakeholders, including system integrators, Medicaid agency staff, and internal project teams.
  8. Understand Medicaid and CMS requirements and how these translate into the MMIS.

Education details:

Any bachelor’s degree required

Disclaimer:

If you feel that this is a good match for your skillsets, please submit a current word version of your resume along with a cover letter describing your skills, experience and salary expectations. We are an Equal Opportunity Employer (EOE).

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