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Medicaid and HIE Processes Specialist

Worldwide Salaried Open

Medicaid and HIE Processes Specialist Raleigh, NC/REMOTE 6+ Months Description: The primary purpose of this position is to work across teams to support various proposed projects in the Medicaid/HIE APD. This role will drive deliverables as the subject matter expert of both Medicaid and HIE processes, systems, and data.

  • This position will work in partnership with external partners and stakeholders, including but not limited to NC HealthConnex participants and DHHS representatives, to work collaboratively to develop and implement quality services to improve population health outcomes in the state of North Carolina.
  • Strong business analysis skills and research capabilities;
  • Ability to lead business requirements development including data and process models, ability to translate business requirements into clear and concise language and system specifications; strong working knowledge of relational databases in a client server environment
  • Strong understanding of NC Medicaid goals, NC HIEA mission and vision, state and federal policies, and data governance.
  • Knowledge of clinical coding systems such as CPT, LOINC, and ICD-10
  • Ability to work independently with minimal supervision;
  • Excellent verbal and written communication skills including the ability to interact and communicate effectively with non-technical clients. Ability to communicate with cross-functional teams and all levels of the organization including IT executives, business managers and other technical staff
  • Strong experience with analytical tools and techniques,
  • Experience with the exchange of healthcare data to support care management and value-based models of care
  • Ability to create and maintain SQL queries, BI dashboards, JIRA, Microsoft office documents (ex. Project. Word, Excel, Visio, and PowerPoint), SharePoint, and Confluence.

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