Senior Medicaid Tech & Policy Analysis Engineer

Conduent, Inc.; Oregon; Hybrid; USD 81,000 - 105,000; Full time

Job summary

Conduent, Inc. seeks a Senior Medicaid Technical Business Analysis Engineer with extensive Medicaid operations, policy, and claims processing expertise.

You will translate regulatory and business requirements into system solutions, collaborating with stakeholders, architects, developers, and QA to support claims processing operations and drive efficiency and compliance. The role emphasizes problem solving, data analysis, and cross-functional collaboration to improve member outcomes while

Qualifications

• 8+ years of healthcare industry experience, preferably MMIS domain.
• Experience interpreting Medicaid policies, CMS regulations, and state program requirements.
• Strong knowledge of Medicaid claims processing and payment systems.
• Ability to research and evaluate documentation, policies, billing manuals, and technical specifications.
• Excellent communication and collaboration with business and technical stakeholders.

Responsibilities

• Partner with business stakeholders to gather, analyze, and document requirements.
• Investigate suspended claims, operational issues, and system defects to identify root causes and solutions.
• Collaborate with development and QA teams to design, test, and validate system enhancements.
• Review Medicaid policy updates and CMS mandates to assess impacts on processes and functionality.
• Develop test strategies and plans for state policy requirements and payment methodologies.
• Support UAT activities and facilitate implementation of system changes.
• Analyze data and trends to provide actionable insights for reporting.

Skills

Medicaid policies

SQL

Claims processing

Regulatory compliance

Business analysis

Stakeholder communication

Problem solving

Data analysis

MMIS

Microsoft Office

Tools

Relational databases

Job description

Conduent, Inc. seeks a Senior Medicaid Technical Business Analysis Engineer with extensive Medicaid operations, policy, and claims processing expertise.

You will translate regulatory and business requirements into system solutions, collaborating with stakeholders, architects, developers, and QA to support claims processing operations and drive efficiency and compliance. The role emphasizes problem solving, data analysis, and cross-functional collaboration to improve member outcomes while