eSense Incorporated
Position: Medicaid SME with experience as Test Lead
Preferred current location: D.C or Richmond, VA
Hybrid: 3 days work from office المنظمة
Job Summary
We are looking for a Medicaid Business Subject Matter Expert (SME) with strong hands‑on experience as a Testing Manager. The ideal candidate will have deep expertise in Medicaid systems and business processes, with proven experience in leading and managing large‑scale testing activities. Strong documentation and communication skills are also required. Key Responsibilities
Analyze and document Medicaid business processes (provider enrollment, eligibility, claims, prior authorization, encounters, reporting territo. Interpret and apply CMS regulations, Medicaid state plan requirements, and federal guidance to ensure system compliance and operational accuracy. Collaborate with development, data, and project teams to design, validate, and test system components and workflows. Lead end‑to‑end testing activities, including test planning, test case development, test execution, defect management, and reporting for both manual and automated testing efforts. அருகினை * Develop and maintain detailed documentation, including Trading Partner Testing Plans, System Integration Plans, Quality Management Plans, Performance Testing Plans, Companion Guides, Test Summary Reports and Results. Conduct and facilitate requirements and testing sessions with stakeholders across policy, operations, compliance, and IT teams. Coordinate and support User Acceptance Testing (UAT) to ensure successful validation of Medicaid system functionality across releases. Leverage data analysis to validate business rules, identify anomalies, and support decision‑making. Provide regular testing reports, issue summaries, and risk assessments to project leadership. Perform other related duties as assigned. Required Qualifications
10+ years of IT systems analysis, with a focus on healthcare systems and Medicaid processes. Subject matter expertise in Medicaid business processes, systems, and regulations. Experience as a Testing Manager overseeing large‑scale testing efforts. Strong documentation and communication skills. Required Education
Bachelor’s degree in business administration or science or a related field. Required Experience
Over 10 years of experience in IT systems analysis, with a strong emphasis on healthcare systems and Medicaid processes. Required Skills
SME in Medicaid In‑depth knowledge of Medicaid business processes, regulations, and systems. Proficient in business process analysis, requirements gathering, and creating detailed documentation. Good problem‑solving, analytical, and communication skills. Preferred
Background working with government contractors is highly desirable. Seniority level
Mid‑Senior level Employment type therp>
Contract Job function
Information Technology, General Business, and Business Development Industries
Public Health and Hospitals and Health Care Rockville, VA $88,100.00-$134,400.00 3 months ago
#J-18808-Ljbffr
We are looking for a Medicaid Business Subject Matter Expert (SME) with strong hands‑on experience as a Testing Manager. The ideal candidate will have deep expertise in Medicaid systems and business processes, with proven experience in leading and managing large‑scale testing activities. Strong documentation and communication skills are also required. Key Responsibilities
Analyze and document Medicaid business processes (provider enrollment, eligibility, claims, prior authorization, encounters, reporting territo. Interpret and apply CMS regulations, Medicaid state plan requirements, and federal guidance to ensure system compliance and operational accuracy. Collaborate with development, data, and project teams to design, validate, and test system components and workflows. Lead end‑to‑end testing activities, including test planning, test case development, test execution, defect management, and reporting for both manual and automated testing efforts. அருகினை * Develop and maintain detailed documentation, including Trading Partner Testing Plans, System Integration Plans, Quality Management Plans, Performance Testing Plans, Companion Guides, Test Summary Reports and Results. Conduct and facilitate requirements and testing sessions with stakeholders across policy, operations, compliance, and IT teams. Coordinate and support User Acceptance Testing (UAT) to ensure successful validation of Medicaid system functionality across releases. Leverage data analysis to validate business rules, identify anomalies, and support decision‑making. Provide regular testing reports, issue summaries, and risk assessments to project leadership. Perform other related duties as assigned. Required Qualifications
10+ years of IT systems analysis, with a focus on healthcare systems and Medicaid processes. Subject matter expertise in Medicaid business processes, systems, and regulations. Experience as a Testing Manager overseeing large‑scale testing efforts. Strong documentation and communication skills. Required Education
Bachelor’s degree in business administration or science or a related field. Required Experience
Over 10 years of experience in IT systems analysis, with a strong emphasis on healthcare systems and Medicaid processes. Required Skills
SME in Medicaid In‑depth knowledge of Medicaid business processes, regulations, and systems. Proficient in business process analysis, requirements gathering, and creating detailed documentation. Good problem‑solving, analytical, and communication skills. Preferred
Background working with government contractors is highly desirable. Seniority level
Mid‑Senior level Employment type therp>
Contract Job function
Information Technology, General Business, and Business Development Industries
Public Health and Hospitals and Health Care Rockville, VA $88,100.00-$134,400.00 3 months ago
#J-18808-Ljbffr