Medicaid Eligibility Process Architect (Lead)

BerryDunn — Assurance, Tax and Consulting; United States; On-site; USD 95,000 - 125,000; Full time

Job summary

BerryDunn is seeking a Business Process Engineer to support Hawaiʻi Med-QUEST’s HR.1 eligibility and enrollment changes, improving Medicaid eligibility processes and aligning with new regulatory requirements. The role focuses on optimizing task assignment, call center workflows, and staff-facing processes.

You will lead current-state analyses, design future-state solutions, and drive implementation using DMAIC, translating policy needs into SOPs, process maps, and training materials.

Qualifications

• Minimum of three years of experience working for or with a state Medicaid agency.
• Experience supporting Medicaid eligibility and enrollment operations, regulatory change, task assignment, workload management, call center operations, or related business processes.
• Ability to lead in a team setting and collaborate with client stakeholders, vendors, and internal project teams.
• Excellent communication, facilitation, writing, editing, presentation, and attention-to-detail skills.

Responsibilities

• Serve as a subject matter expert on HR.1 eligibility and enrollment business process redesign, operations, policy alignment, and implementation planning.
• Support changes needed to meet state and federal regulatory requirements for Medicaid eligibility and enrollment operations.
• Lead and support current-state analysis, future-state design, process improvement, and implementation activities for eligibility and enrollment workflows using the DMAIC framework.
• Translate business needs, policy requirements, regulatory changes, and stakeholder feedback into clear requirements, process maps, SOPs, implementation materials, and recommendations.
• Facilitate meetings, interviews, workgroups, planning sessions, and process improvement events with eligibility and enrollment stakeholders, operations teams, vendor partners, and related external partners.
• Use Jira and SharePoint to track work, document decisions, maintain project materials, and support reporting and review processes.

Skills

Process redesign

Medicaid knowledge

Stakeholder management

DMAIC

Requirements gathering

Facilitation

Jira

Education

Three years Medicaid experience

Tools

Microsoft Project

Excel

Word

PowerPoint

Visio

SharePoint

Teams

Outlook

Jira

Webex

Zoom

Job description

BerryDunn is seeking a Business Process Engineer to support Hawaiʻi Med-QUEST’s HR.1 eligibility and enrollment changes, improving Medicaid eligibility processes and aligning with new regulatory requirements. The role focuses on optimizing task assignment, call center workflows, and staff-facing processes.

You will lead current-state analyses, design future-state solutions, and drive implementation using DMAIC, translating policy needs into SOPs, process maps, and training materials.