MMIS Stakeholders Consultant (Jobs in Jackson, MS)   Requirement id 157391 Job title Consultant Job location in Jackson, MS Skills required Medicaid Experience, MMIS, Enrollment Management, Stakeholders Open Date 06-Mar-2026 Close Date Job type Contract Duration 12 Months Compensation DOE Status requirement --- Job interview type --- Apply    Email Recruiter: coolsoft Job Description Consultant: Medicaid Experience, MMIS, Enrollment Management, Stakeholders Start date : 4/15/2026 End Date : 4/14/2027 Submission deadline : 3/13/2026 3:00:00 PM Client Info : Medicaid Note: * 100% onsite required * Note: - Applicants who do not meet all of the required skills/experience minimums may not be considered further. - The awarded applicant will be required to execute a Business Associate Agreement (BAA) with DOM. - The period of performance will be for one-year intervals with the ability to renew for up to five (5) years based on mutual agreement of the parties. Description : The Medicaid SME will provide subject matter expertise related to Medicaid program data, policies, and operational workflows to support the successful implementation and operationalization of the Program Integrity (PI) tool. The SME will collaborate with technical teams, program staff, vendors, and project leadership to ensure the PI solution effectively leverages Medicaid data to detect, prevent, and investigate fraud, waste, and abuse. Key Responsibilities: Data Domain Expertise - Provide expert guidance related to the structure, relationships, and usage of Medicaid data domains, including: Member Data: • Eligibility and enrollment data • Demographic and coverage information • Managed care enrollment and attribution • Member identifiers and cross-system matching Provider Data: • Provider enrollment and credentialing • Provider taxonomy and specialty classifications • Provider affiliations and group relationships • National Provider Identifier (NPI) and provider registry integration2 Claims Data: • Professional, institutional, and pharmacy claims • Claim lifecycle and adjudication processes • Service codes (CPT, HCPCS, ICD, DRG) • Payment and encounter processing • Claims adjustments, voids, and resubmissions Managed Care Data: • Managed Care Organization (MCO) encounter data • Capitation payments • Managed care reporting requirements • Encounter-to-claim mapping and validation Program Integrity Support: • Advising on data requirements for fraud, waste, and abuse detection • Assisting with data mapping and data model validation for the PI tool • Supporting development of analytics, rules, and investigative workflows • Identifying data quality issues and remediation strategies • Helping define use cases and investigative scenarios • Ensuring accurate interpretation of Medicaid policy and program rules within the tool Implementation Support: • Collaborating with system integrators and vendors on data ingestion and transformation • Supporting data validation, testing, and reconciliation • Participating in requirements gathering and design sessions • Providing business context for technical teams • Reviewing system outputs for accuracy and relevance • Supporting User Acceptance Testing (UAT) Stakeholder Collaboration: • Program Integrity leadership • Data analytics teams • Medicaid program staff • IT and data architecture teams • System implementation vendors • Managed Care oversight teams Work Products: • Medicaid data domain documentation validation • Data mapping and data dictionary validation • Program Integrity use cases and business rules validation • Data quality assessments and recommendations • Support documentation for system configuration validation • UAT participation and validation feedback • Implementation support reports and findings validation   Call 502-379-4456 Ext 100 for more details. Please provide Requirement id: 157391 while calling.   Other jobs in MS: Jackson (1),    Medicaid Experience job openings in other states Jobs List IT Healthcare Consultant Project Manager - 9814 Create date: 13-Feb-2026 Start date : 03/08/2026 End Date : 12 Months from projected start date Submission deadline : 2/20/2026 5:00:00 PM Client Info : SCDHHS Note: * Interview Process: 1 round, Virtual/Online * Duration of the Contract: 12 months * Possibility for Extension: Yes Project Manager Jobs in SC Columbia Manager - (in Columbia, SC)) MES Business Quality Assurance Analyst (763381) Create date: 04-Jun-2025 Start date : 06/02/2025 End Date : 06/01/2026 Submission deadline : 06/09/2025 Client Info : NCDHHS-HB Note: * Agency Interview Type : Webcam Interview Only * Hybrid Description : MES PBA Business Quality Assurance Analyst NC Department of Health an.... (This job is for - job Jobs in NC Raleigh Analyst - (in Raleigh, NC)) ITSAC 529210068C Project Manager 3 -SP Create date: 07-Mar-2022 Note: RTR form must be signed by the candidate. Note: The worker may be required to work remotely 3 days a week and 2 days onsite Note: Total estimated hours per Candidate shall not exceed 856 hours Submission Deadline: 3/15/2022 5:00 PM CT Start Date: 4/4/2022 End Date : 8/31/2022 Client: Texas Heal.... (This job is for - Analytical Skills Jobs in TX Austin Manager - (in Austin, TX)) Business Analyst - 79928 Create date: 06-Oct-2021 Note: * Phone or video call Description: Requirements Years of work experience: 1 year(s) General skills Must have: Medicaid Experience IT skills CMS Business Modeling MS Project (This job is for - CMS Jobs in AL Montgomery Analyst - (in MONTGOMERY, AL)) MES Integration Architect (640141) Create date: 17-Nov-2020 Start Date : 12/21/2020 End Date : 12/20/2021 Submission Deadline : 11/23/2020 * Client Info : NCDHHS-ITSM * Note : Webcam Interview Only Description: The Department of Health and Human Services Information Technology Division is seeking Enterprise, Technical and Solutions.... (This job is for - MITA Jobs in NC Raleigh Architect - (in Raleigh, NC))     (Consultant: Medicaid Experience, MMIS, Enrollment Management, Stakeholders in Jackson, MS)

Featured Jobs SaaS Powerapps Dataverse Engineer (Jobs in Austin, Texas) NIST PING Tester (Jobs in Raleigh, North Carolina) SASS Architect (Jobs in Polk County, Iowa) Business Analyst Administrator. - Analyst (Jobs in Atlanta, Georgia) Business Intelligence Administrator (Jobs in Fayetteville, North Carolina Consultant (Jobs in Columbia, South Carolina) MMIS Stakeholders Consultant (Jobs in Jackson, Mississippi) Budgeting ServiceNow Manager (Jobs in Blythewood, South Carolina) NVision SQR Engineer (Jobs in Columbia, South Carolina) - Analyst (Jobs in Austin, Texas)