Project Delivery Lead

Management Consulting | Core Business Operations
Same job available in 2 locations

Austin, Texas, United States

Austin, Virginia, United States

Position Summary

MMIS Application Track Lead

Are you a Data Analytics/ Informatics subject matter expert with technical/functional Medicaid Data Analytics experience? Are you a MMIS application development expert? Do you want to help us transform the Medicaid market as it embraces modularization, and we help our clients create a new future for Medicaid technology? If you like to design and operate a differentiated customer and provider experience in Medicaid, let us have a conversation. 

 

Work you’ll do

Role Summary:

  • Works with application development and/or application maintenance in the application domain in a Medicaid, MMIS setting or in a health insurance Managed Care Organization setting. 
  • Works directly with the Senior Manager leading the DDI or System Operations transition and will have a team of developers and infrastructure personnel to support. 
  • Will ensure developers are trained and prepare for operational readiness demonstrations. 
  • Works with the scrum masters and runs agile maintenance and development sprints. 

 

Application domain details:

  • Claims and encounters:
    •    EDI X12 837 claims management for FFS claims
    •    EDI Clearinghouse 
    •    Encounter data processing from a Medicaid perspective
    •    Medicaid and CHIP data warehouse and operational data store for claims and encounter sub systems
  • Eligibility:
    •    Medicaid eligibility determination
  • Pricing, rate setting, contracts
    • Pricing and rate setting application development
    • Fee for service price schedule management
    • MCO FFS request management
  • Long term care and behavioral health
    • Long term care (LTC) portal including clinical assessment submission, online authorization
    • Behavioral health– contract and payment management, enrollee management, KPI and metrics management
  • Portals and outreach
    • Member and provider portals including enrollment and eligibility inquiries, requesting ID cards, provider search, FFS pricing requests made by providers
    • Authorization submission and data management
    • Electronic visit verification management
    • EDI X12 270/271 eligibility benefit enquiry
  • Reporting and analytics for Medicaid and CHIP claims, enrollment, rates, providers
  • Batch and interface operations including FTP, scheduling and error handling within specified SLAs

 

Technology platforms:

  • Assist in planning, architecture, analysis and design of enterprise technology solutions that satisfy business requirements for large complex systems in the Medicaid/MMIS or health insurance claims and pricing space.

 

Qualifications

 

Required:

  • Associates Degree from accredited college or university

 

Preferred:

  • Agile development experience and SCRUM certification are pluses
  • Demonstrated experience in one of the following concentrations related to the application domains:
    • 5+ years of custom development experience:
      • Windows/.NET/Sqlserver
      • Windows/Java/Oracle12x and upward
    • 5+ years of Tableau/ Qlik, ArcGIS experience
    • 5+ years of EDI EDIFECS XEngine / equivalent experience
    • 5+ years of TANDEM/HP Nonstop platform - 5-7 years development experience (GUARDIAN / OSS, COBOL, C, C++, JAVA
    • Hands-on TANDEM/NonStop X Systems development; Using Tools and Languages TAL, TACL, Tandem COBOL, TANDEM C++, ENSCRIBE, ENFORM, SQL MP / MX, TANDEM pathway, Tandem internal messaging system, FUP, BATCHCOM, SQLCI, Host security module, tokenization and encryption

Our people and culture

Our diverse, equitable, and inclusive culture empowers our people to be who they are, contribute their unique perspectives, and make a difference individually and collectively. It enables us to leverage different ideas and perspectives, and bring more creativity and innovation to help solve our client most complex challenges. This makes Deloitte one of the most rewarding places to work. Learn more about our inclusive culture.

Professional development

From entry-level employees to senior leaders, we believe there’s always room to learn. We offer opportunities to build new skills, take on leadership opportunities and connect and grow through mentorship. From on-the-job learning experiences to formal development programs, our professionals have a variety of opportunities to continue to grow throughout their career.


As used in this posting, "Deloitte" means Deloitte Consulting LLP, a subsidiary of Deloitte LLP. Please see www.deloitte.com/us/about for a detailed description of the legal structure of Deloitte LLP and its subsidiaries.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or protected veteran status, or any other legally protected basis, in accordance with applicable law.

Requisition code: 133253

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