Medicaid and CHIP Managed Care Compliance Specialist (Remote)
Remote, USA
Full-time
Posted 2025-03-14
Medicaid and CHIP Managed Care Compliance Specialist Location: Remote About Us: Known for 'Delighting the Client' through performance, innovation, and an employee-centric culture, S2Tech is a fast-growing IT consulting company serving clients in over a quarter of the United States. We are widely recognized as a leading provider of both technical and business services in support of Health and Human Services related projects. Feel free to learn more at www.s2tech.com. Why S2Tech?: ? Stable privately-owned company with a strong reputation for building long-term client relationships through the delivery of consistent value-based service ? 25-year history of providing IT and Business services to private customers and government programs throughout the United States ? Expansive client portfolio and active projects - employees benefit from innovative project exposure and in-house skill development training/courses ? Corporate culture that emphasizes the importance of family and promotes healthy work-life balance ? Offer competitive pay and a range of benefits including: ? Medical / Dental / Vision Insurance - insurance premium assistance provided ? Additional Insurance (Life, Disability, etc.) ? Paid Time Off (Vacation & Sick Leave) ? 401(k) Retirement Savings Plan & Health Savings Account ? Various training courses to promote continuous learning ? Corporate Wellness Program ? Be part of a company that gives back through its non-profit organization, Fortune Fund, which was launched in 2001. The goal of the Fortune Fund is to close the rural/urban divide by ensuring children in rural communities in India and the United States understand the importance of education & are aware of professional career opportunities allowing them to link their professional & educational goals Job Overview: We are seeking a Medicaid and CHIP Managed Care Compliance Specialist to support the Department of Health (DOH) in adhering to the CMS Final Rule on 'Medicaid and Children's Health Insurance Program (CHIP) Managed Care Access, Finance, and Quality.' The candidate will focus on analyzing CMS guidance, developing a requirements matrix, and contributing to the creation of a roadmap for compliance. Responsibilities: ? Interpret and analyze CMS Final Rule guidance related to Medicaid and CHIP managed care ? Collaborate with DOH and client project leadership to develop a detailed project schedule ? Assist in the creation of a CMS Final Rule Requirements Matrix, focusing on managed care access, finance, and quality ? Engage in stakeholder interviews to understand existing managed care processes and identify compliance gaps ? Contribute to the development of a Gap Analysis and Implementation Roadmap, offering strategic recommendations for compliance ? Provide ongoing support to DOH in their efforts to meet CMS managed care requirements Qualifications: ? Bachelor's degree in Healthcare Management, Public Health, or a related field ? At least 5 years of experience in Medicaid and CHIP managed care, with a focus on compliance ? Strong understanding of CMS regulations concerning managed care ? Experience in project planning, gap analysis, and roadmap development ? Excellent communication and analytical skills ? Ability to work independently and as part of a remote team Preferred Qualifications: ? Knowledge of eMedNY system operations ? Experience working with 'Big 4' consulting firm S2Tech is committed to hiring and retaining a diverse workforce. We are an equal opportunity employer making decisions without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected class.
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