Medicaid AI & Automation Transformation Lead

International Business Machines Corporation; Burlingame (CA); On-site; USD 140,000 - 190,000; Full time

Job summary

IBM Consulting in California seeks a Business Transformation Consultant specializing in Application Automation. You will drive automation and AI-driven modernization for Medicaid-related portfolios, translating policy into technical roadmaps while leading cross-functional stakeholder engagement.

The role emphasizes compliance with CMS/HIPAA, governance through CAMMIS, and cloud migration alongside legacy MMIS modernization. Four-day onsite client work is expected.

Qualifications

• Experience in Medicaid MMIS, healthcare IT systems, and managed care environments.
• Deep knowledge of Medicaid policies, compliance requirements, and program operations.
• Familiarity with CMS regulatory requirements governing state Medicaid programs.
• Understanding HIPAA compliance, data governance, and security in Medicaid environments.
• Strong stakeholder management and relationship-building across clinical, operational, and technical teams.

Responsibilities

• Medicaid Domain Leadership & Strategy: Serve as the primary subject matter expert on California Medicaid policies, MMIS applications, and CMS/Federal regulatory requirements.
• Business Requirements Analysis & Translation: Analyze complex Medicaid business requirements and translate them into technical specifications and roadmaps.
• Stakeholder Engagement & Client Management: Build relationships across DHCS and CA Medicaid stakeholders to align on priorities and timelines.
• Innovation Initiative Assessment & Planning: Evaluate AI, automation, and modernization initiatives for Medicaid compliance and feasibility.
• Technical Guidance & Advisory Support: Guide technical teams on Medicaid data requirements and policy implications.
• Program Governance & Recommendations: Contribute to CAMMIS governance with prioritization and resource guidance.
• Cloud Migration & Modernization Support: Advise on AWS cloud transformation and MMIS modernization.

Skills

Medicaid MMIS

Healthcare IT

CMS regulations

HIPAA compliance

Stakeholder management

Tools

Process mining tools

RPA tools

AI/GenAI tools

Job description

IBM Consulting in California seeks a Business Transformation Consultant specializing in Application Automation. You will drive automation and AI-driven modernization for Medicaid-related portfolios, translating policy into technical roadmaps while leading cross-functional stakeholder engagement.

The role emphasizes compliance with CMS/HIPAA, governance through CAMMIS, and cloud migration alongside legacy MMIS modernization. Four-day onsite client work is expected.