Technology Solutions Management Consultant

Role Overview

We are seeking an experienced Technology Solutions Management Consultant with deep expertise in Medicaid claims processing, encounter data, and related healthcare IT systems. The ideal candidate will bring strong knowledge of Medicaid regulations, EDI transactions, and MMIS platforms, while collaborating cross-functionally to ensure compliance and system accuracy.

Core Responsibilities

• Serve as the Subject Matter Expert (SME) for Medicaid claims processing and encounter data systems.
• Provide expert-level knowledge of the Medicaid claims life cycle, including HIPAA X12 transactions (837, 835) and NCPDP formats.
• Collaborate with cross-functional teams (IT, QA, Business Analysts) to ensure accurate implementation of Medicaid requirements.
• Analyze and interpret Medicaid policy changes and translate them into detailed system requirements.
• Support testing, validation, and quality assurance of Medicaid claims software applications.
• Develop and maintain documentation, training materials, and process workflows.
• Participate in audits, compliance reviews, and quality assurance initiatives.
• Provide mentorship and guidance to junior team members and stakeholders.

Required Qualifications

• Bachelor’s degree in healthcare administration, Information Systems, or a related field (Master’s preferred).
• 5+ years of experience in Medicaid claims processing or healthcare IT systems.
• Strong understanding of Medicaid regulations, policies, and managed care programs.
• Proficiency with Medicaid Management Information Systems (MMIS) and encounter data systems.
• Experience with claims adjudication systems and Electronic Data Interchange (EDI).
• Familiarity with CMS guidelines and state-specific Medicaid programs.
• Strong analytical, problem-solving, and communication skills.
• Ability to work independently and manage multiple priorities in a fast-paced environment.

Preferred Skills

• Experience working in Agile or Scrum environments.
• Knowledge of data analytics tools such as SQL and Tableau.
• Prior experience supporting state Medicaid agencies or CMS contractors.

Pay Transparency Laws in some locations require disclosure of compensation and/or benefits-related information.  For this position, actual salaries will vary and may be above or below the range based on various factors including but not limited to location, experience, and performance. In addition to base pay, this position, based on business need, may be eligible for a bonus or incentive. In addition, Conduent provides a variety of benefits to employees including health insurance coverage, voluntary dental and vision programs, life and disability insurance, a retirement savings plan, paid holidays, and paid time off (PTO) or vacation and/or sick time. The estimated salary range for this role is $101,063 - $130,000. 

Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on them. You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day.

Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law.

For US applicants: People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by submitting their request through this form that must be downloaded:  click here to access or download the form.  Complete the form and then email it as an attachment to [email protected]. You may also click here to access Conduent's ADAAA Accommodation Policy.