Medicaid Systems Lead — Policy, Claims & Analysis

Conduent, Inc.; United States; Remote; USD 81,000 - 105,000; Full time

Benefits offered by this job

Health and welfare benefits

Retirement savings plan

Career growth opportunities

Paid time off

Great work environment

Job summary

Conduent is seeking a Senior Medicaid Technical Business Analysis Engineer with deep Medicaid operations, policy, and claims processing experience. You will work across business and technical teams to translate regulatory requirements into system solutions and drive improvements in efficiency and compliance.

In this role you will analyze data, support UAT, and develop test strategies while maintaining strong communication with stakeholders and ensuring alignment throughout the project lifecycle.

Qualifications

• Experience interpreting Medicaid policies and CMS regs.
• Strong Medicaid claims processing knowledge.
• Ability to analyze data and translate requirements.
• Excellent communication with business and tech teams.
• 8+ years in healthcare, MMIS domain preferred.
• SQL and relational database proficiency.

Responsibilities

• Gather, analyze, and document business and system requirements with stakeholders.
• Investigate suspended claims and system defects to identify root causes.
• Collaborate with dev and QA to design and validate improvements.
• Assess policy updates and CMS mandates for impact.
• Support issue resolution with regulatory guidance.
• Document and improve business processes for efficiency.
• Serve as liaison between business and technical teams.
• Develop test strategies and plans for state policy and payments.
• Support UAT and successful implementation of changes.
• Analyze data trends to provide actionable insights.

Skills

Medicaid policies

CMS regulations

Medicaid claims processing

SQL knowledge

Data analysis

Communication skills

Independent research

Stakeholder collaboration

MMIS domain knowledge

Presentation skills

Job description

Conduent is seeking a Senior Medicaid Technical Business Analysis Engineer with deep Medicaid operations, policy, and claims processing experience. You will work across business and technical teams to translate regulatory requirements into system solutions and drive improvements in efficiency and compliance.

In this role you will analyze data, support UAT, and develop test strategies while maintaining strong communication with stakeholders and ensuring alignment throughout the project lifecycle.