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 Perk 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.
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
Robust troubleshooting and production support capability
What you should expect in this role
Remote Opportunities