Medicaid & Government Programs Functional Consultant

CAYS Inc; City of Albany (NY); On-site; USD 110,000 - 150,000; Full time

Job summary

CAYS Inc in Albany, NY seeks a Functional Consultant to support Medicaid programs and healthcare projects. You will collaborate with State agencies, MCOs, and vendors to analyze requirements, document BRDs/FRDs, and guide testing through UAT and defect resolution.

Candidates should have HIPAA 834/278 experience, strong SQL/data analysis skills, and proficiency with JIRA, Confluence, Visio, and MS Office. This is a long-term, on-site role in Albany, NY.

Qualifications

• Experience as functional/business analyst or consultant in healthcare, Medicaid, or government programs.
• Excellent stakeholder management and communication with State agencies, MCOs, and vendors.
• Strong understanding of Medicaid operations, LTSS, and enrollment processes.
• Experience with HIPAA 834 and/or 278 transaction sets and implementation guides.
• Experience creating BRDs/FRDs, workflow diagrams, data mapping specs, and interface docs.
• Supporting development and testing teams through clarification, UAT, issue resolution, and defect mgmt.
• Proficiency with JIRA, Confluence, Visio, and MS Office.
• Experience supporting HIPAA 834 Enrollment and HIPAA 278 Authorization transactions.
• Familiarity with MLTC enrollment workflows and non-MAGI eligibility.
• Working knowledge of SQL and data analysis for reconciliation and root-cause investigation.

Skills

Healthcare domain

Stakeholder management

HIPAA 834/278

BRD/FRD/docs

UAT/Defect mgmt

SQL/Data analysis

Tools

JIRA

Confluence

Visio

MS Office

Job description

CAYS Inc in Albany, NY seeks a Functional Consultant to support Medicaid programs and healthcare projects. You will collaborate with State agencies, MCOs, and vendors to analyze requirements, document BRDs/FRDs, and guide testing through UAT and defect resolution.

Candidates should have HIPAA 834/278 experience, strong SQL/data analysis skills, and proficiency with JIRA, Confluence, Visio, and MS Office. This is a long-term, on-site role in Albany, NY.