Medicaid Eligibility Business SME | NTT DATA Services

Clipped from:

Req ID: 233018

NTT DATA Services strives to hire exceptional, innovative and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking organization, apply now.

We are currently seeking a Medicaid Eligibility Business SME to join our team in Nashville, Tennessee (US-TN), United States (US).

The Medicaid Eligibility Subject Matter Expert (SME) will work directly with the client’s operations staff to assist with ongoing system enhancement work. This includes but is not limited to participation in definition, design, testing and implementation of changes in each of the system releases. This Medicaid Eligibility SME will be a valued member of the client’s Business Services Support team. The Medicaid Eligibility SME will work collaboratively with the client and other vendors on the client’s projects and initiatives. The Medicaid Eligibility SME will provide valuable business analysis services and subject matter expertise through consultation with the client. The Medicaid Eligibility SME will integrate seamlessly with the client team to ensure that business needs are met by managing and driving change using knowledge and experience.

The Medicaid Eligibility SME will assist the team with implementing these changes driven by requirements definition through final implementation and stabilization. The NTT DATA staff will perform the follow responsibilities:

  • Work collaboratively with the Member Services team(s) leveraging their Eligibility business operations skills and expertise as well as their systems implementation experience, to improve the operational efficiency of the team and increase the quality of the systems enhancements and changes that go into production.
  • Work collaboratively with the Member Services Partner Support team supporting onboarding and administrative tasks, including trouble shooting and problem solving.
  • Participate in identifying any operational impacts created by proposed system changes and recommend modifications to business workflow and processes.
  • Participate in requirements definition and design, business workflow development, design, and improvement, the review of system integration test case and results, and the review of user acceptance test case and results.
  • Participate in implementation planning and execution activities, such as operational readiness tests, parallel tests, and beta tests.
  • Develop and execute Eligibility Business Operations Test Cases as part of the User Acceptance phase for each system release.
  • Collaborate with the Enterprise Testing Management Office (eTMO) to ensure that testing standards and processes are maintained as the Eligibility Business Operations Test Cases are executed and defects are identified.
  • Employee is expected to undertake any additional duties as they are assigned by their manager.


Basic Qualifications:

  • Bachelor’s degree or 4 Years additional equivalent experience
  • Minimum of 5 years of experience including:
  • A minimum of 3 years’ experience conducting meetings and making presentations
  • A minimum of 2 years’ experience demonstrating strong problem-solving and customer service skills
  • A minimum of 1 year of business experience working on large complex system implementation and/or enhancement projects
  • A minimum of 3 years’ experience interacting with vendors and third parties effectively to meet commitments and milestones.
  • A minimum of 1 year testing experience
  • Must be able to travel to Nashville, Tennessee 50% of the time, post COVID-19 restrictions


Preferred Skills:

  • Experience interpreting complex eligibility determination rules, policy, and processes
  • Experience in the health and human services related industry
  • Ability to work independently and manage work to a defined schedule
  • Strong written and verbal communication skills
  • Team player and a consistent, dependable performer with an excellent work ethic, flexible “can-do” attitude, and a results-driven commitment to success
  • Ability to apply industry best practices and future state/federal mandates to existing systems
  • Excels at using quantitative data to drive recommendations and decisions


For Colorado Candidates

In compliance with the Colorado Equal Pay Transparency Rules, NTT DATA provides a reasonable range of compensation for roles that may be hired in Colorado. For a candidate in the state of Colorado only, the starting pay range for this role is 72,700 to 85,000. Actual compensation will depend on a number of factors, including actual work location, relevant experience (internal or external), technical skills, and other qualifications.

This position is eligible for company benefits including medical, dental, and vision insurance with an employer contribution, flexible spending or health savings account, life and AD&D insurance, short and long-term disability coverage, paid time off, employee assistance, participation in a 401k program with company match, and additional voluntary or legally-required benefits.

About NTT DATA Services

NTT DATA Services is a global business and IT services provider specializing in digital, cloud and automation across a comprehensive portfolio of consulting, applications, infrastructure and business process services. We are part of the NTT family of companies, a partner to 85 % of the Fortune 100.

NTT DATA Services is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team.