Summary Seeking a highly skilled Reference SME with strong expertise in Medicaid Reference Configuration, BPA setup, Oracle, C, and Pro*C technologies. The candidate will manage configuration and maintenance of Benefit Plans, Assignment Plans, Provider Contracts, Reference Tables, Rule Metadata, and BPA configuration components used in claims adjudication.The role requires deep understanding of Medicaid reference data structures and how reference configuration impacts claims, provider enrollment, reimbursement, audits, and policy administration.
Your role in our mission Required Technical Skills Programming Skills
- Benefit Classifications
- Rule Sheets
- Release Management
- Provider Contracts
- Benefit Plan Hierarchies
- Assignment Plan Hierarchies
What We're Looking For Ideal Candidate Profile Reference SME (9+ Years) 60% Technical | 40% Functional
- Solid Oracle, C, Pro*C expertise
- Deep BPA configuration knowledge
- Provider Contract and Benefit Plan maintenance experience
- Rule Metadata and Rule Sheet management
- Configuration governance and release management expertise
- Strong troubleshooting and production support capability