Medicaid MMIS Transformation Lead: AI & Automation

International Business Machines Corporation

Capitola (CA)

On-site

USD 150,000 - 210,000

Full time

5 days ago

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Job summary

IBM Consulting is seeking a skilled Business Transformation Consultant focused on Medicaid and application automation in California. You will analyze Medicaid portfolios, identify automation opportunities using AI/GenAI, and guide modernization efforts across clinical, operational, and technical teams.

The role emphasizes policy compliance, CMS guidelines, and HIPAA considerations, with the on-site client engagement four days a week.

Qualifications

Experience with Medicaid Management Information Systems (MMIS) and healthcare IT systems.
Deep knowledge of Medicaid policies, compliance requirements, and program portfolio operations.
Familiarity with CMS regulatory requirements governing state Medicaid programs.
Experience translating policies into system and operational changes.
Understanding of HIPAA security and data governance in Medicaid environments.

Responsibilities

Drive automation transformation and analyze client application portfolios for automation opportunities.
Advise on AI/GenAI applications and automation use cases in healthcare and government settings.
Engage stakeholders across clinical, operational, and technical teams to align priorities.
Develop business cases and roadmaps for modernization and digital transformation.
Provide technical guidance on Medicaid-specific data requirements and policy implications.
Contribute to program governance and strategic decision-making for transformation initiatives.
Support cloud migration and modernization efforts, including AWS cloud transformation.