Medicaid Eligibility SME
$91.04k - $136.56kNTT Data
Req ID:376557NTT DATA strives to hire exceptional, innovative and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking organization, apply now.We are currently seeking a Medicaid Eligibility SME to join our team in Nashville, Tennessee (US-TN), United States (US).This Medicaid Eligibility Subject Matter Expert (SME) will be a valued member of the client’s Business Services Support team. He/she will work directly with the client’s operations staff to assist with ongoing system enhancement work. This includes but is not limited to participation in definition, design, testing and implementation of changes in each of the system releases. The Medicaid Eligibility SME will work collaboratively with the client and other vendors on the client’s projects and initiatives. He/she will provide valuable business analysis services and subject matter expertise through consultation with the client. The Medicaid Eligibility SME will integrate seamlessly with the client team to ensure that business needs are met by managing and driving change using knowledge and experience.Job Responsibilities Include:Work collaboratively with the Member Services team leveraging their Eligibility business operations skills and expertise as well as their systems implementation experience, to improve the operational efficiency of the team and increase the quality of the systems enhancements and changes that go into production.Work collaboratively with the Member Services Partner Support team supporting onboarding and administrative tasks, including trouble shooting and problem solving.Support Member Services Member communication team with daily notice review, researching notice issues, review of data fixes and notice User Acceptance TestingParticipate in identifying any operational impacts created by proposed system changes and recommend modifications to business workflow and processes.Participate in requirements definition and design, business workflow development, design, and improvement, the review of system integration test case and results, and the review of user acceptance test case and results.Participate in implementation planning and execution activities, such as operational readiness tests, parallel tests, and beta tests.Develop and execute Eligibility Business Operations Test Cases as part of the User Acceptance phase for each system release.Collaborate with the Enterprise Testing Management Office (eTMO) to ensure that testing standards and processes are maintained as the Eligibility Business Operations Test Cases are executed and defects are identified.Employee is expected to undertake any additional duties as they are assigned by their manager.Basic Qualifications:Bachelor’s degree or equivalent experienceA minimum of 6 years’ experience in the health and human services eligibility determinationA minimum of 1 years’ experience interpreting complex eligibility determination rules, policy, and processesA minimum of 3 years’ experience conducting meetings and making presentationsA minimum of 3 years’ business experience working on large complex system implementation and/or enhancement projectsA minimum of 1 year experience interacting with vendors and third parties effectively to meet commitments and milestonesA minimum of 1 year testing experienceMust be able to travel to Nashville, Tennessee, as requestedPreferred Skills:Ability to work independently and manage work to a defined scheduleStrong written and verbal communication skillsStrong problem-solving and customer service skillsTeam player and a consistent, dependable performer with an excellent work ethic, flexible “can-do” attitude, and a results-driven commitment to successAbility to apply industry best practices and future state/federal mandates to existing systemsExcels at using quantitative data to drive recommendations and decisionsWhere required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting pay range for this remote role is $91,040 - $136,560. This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on a number of factors, including the candidate’s actual work location, relevant experience, technical skills, and other qualifications. This position may also be eligible for incentive compensation based on individual and/or company performance. This position is eligible for company benefits including medical, dental, and vision insurance with an employer contribution, flexible spending or health savings account, life and AD&D insurance, short and long term disability coverage, paid time off, employee assistance, participation in a 401k program with company match, and additional voluntary or legally-required benefits.About NTT DATANTT DATA is a $30 billion business and technology services leader, serving 75% of the Fortune Global 100. We are committed to accelerating client success and positively impacting society through responsible innovation. We are one of the world's leading AI and digital infrastructure providers, with unmatched capabilities in enterprise-scale AI, cloud, security, connectivity, data centers and application services. our consulting and Industry solutions help organizations and society move confidently and sustainably into the digital future. As a Global Top Employer, we have experts in more than 50 countries. We also offer clients access to a robust ecosystem of innovation centers as well as established and start-up partners. NTT DATA is a part of NTT Group, which invests over $3 billion each year in R&D.Whenever possible, we hire locally to NTT DATA offices or client sites. This ensures we can provide timely and effective support tailored to each client’s needs. While many positions offer remote or hybrid work options, these arrangements are subject to change based on client requirements. For employees near an NTT DATA office or client site, in-office attendance may be required for meetings or events, depending on business needs. At NTT DATA, we are committed to staying flexible and meeting the evolving needs of both our clients and employees. NTT DATA recruiters will never ask for payment or banking information and will only use @nttdata.com, @nttdatafed.com and @talent.nttdataservices.com email addresses. If you are requested to provide payment or disclose banking information, please submit a contact us form, .NTT DATA endeavors to make accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact us at . This contact information is for accommodation requests only and cannot be used to inquire about the status of applications. NTT DATA is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. For our EEO Policy Statement, please click here. If you'd like more information on your EEO rights under the law, please click here. For Pay Transparency information, please click here.Posting Date:06/15/2026Department:IT Consultant - 1490510281
$14 per hour
...Eligibility Assistant This position is located in Nashville, IN. Knowledge Services has a great opportunity for a strong customer... ...assistance. Programs include TANF (cash assistance), SNAP, and Medicaid. The Eligibility Assistant staff are front desk staff who are...SuggestedWork at officeLocal areaImmediate startMonday to Friday- ...payment execution, file transmission, and connectivity. Serve as SME for disbursements in ERP consolidation (Oracle Fusion),... ...who are regularly scheduled to work 30 or more hours per week are eligible for the following benefits: medical (choice of 3 plans), dental,...SuggestedHourly payLocal area
$21 - $26 per hour
Eligibility Associate Representative (Customer Service Representative) Location: Fully Remote (U.S. Based) Eligible States: All U.S. states except New York, California, Hawaii, and Alaska Pay Range: $21.00 $26.00 per hour Start Date: July 2026 Assignment Length: through...SuggestedHourly payFull timeWork at officeLocal areaRemote workFlexible hoursRotating shiftAfternoon shift$3,229 - $4,041 per month
Eligibility Counselor 1* - 12162025-73640 Join the State of Tennessee in Morristown, TN to apply for the Eligibility Counselor 1* role. This full‑time position is located in the Department of Human Services, Adult and Family Services Division, Hamblen County. Opening Date...SuggestedFull timeFor contractorsWork at office$169.5k - $233k
...access to medical, dental, vision, and basic life insurance, a 401(k) plan, and the ability to purchase company stock at a discount. Eligible employees may also enroll in a deferred compensation plan or the Executive Deferral Plan. Jacobs has an unlimited U.S....SuggestedFull timeContract workFor contractorsRemote work- A leading technology solutions provider in the United States seeks a dedicated technical support professional. This role focuses on providing support for various enterprise products and includes responsibilities like incident management, documentation, and collaboration...Remote job
$144.9k - $265.8k
Location: Anywhere in Country At EY, we're all in to shape your future with confidence. We'll help you succeed in a globally connected powerhouse of diverse teams and take your career wherever you want it to go. Join EY and help to build a better working world. Consulting...Summer holidayFlexible hours- Agri-Power, Inc. is looking for a Service Technician to perform diagnostics and repairs on farm equipment. The role requires at least 3 years of experience in diesel or heavy equipment technology, alongside a dedication to maintaining high customer satisfaction. Key responsibilities...Hourly pay
$114.6k - $234.6k
The Enterprise Technical Subject Matter Expert (SME) - Electrical Systems is responsible for developing, standardizing, and delivering... ...Range in USD from: $114,600 to $234,600 per annum. May be eligible for bonus, equity, and compensation deferral.Oracle maintains broad...Temporary workRemote workFlexible hours$25 - $50 per hour
Job Description Job Description Company Description At Audi Downtown Nashville , a Sonic Automotive family dealership, you'll find the opportunities, resources, and support you need to grow and develop professionally. Our 100+ dealerships are concerned with ...Hourly payTemporary workRelocation packageFlexible hours- Develop and maintain the voice of Adventure Ted using cutting-edge technology and AI tools to ensure consistent character portrayal across animations, virtual events, and multimedia projects. Collaborate with Childhood Cancer Society’s creative and production teams ...Remote job
$114.6k - $234.6k
The Enterprise Technical Subject Matter Expert (SME) - Mechanical Systems is responsible for developing, standardizing, and delivering... ...Range in USD from: $114,600 to $234,600 per annum. May be eligible for bonus, equity, and compensation deferral.Oracle maintains broad...Temporary workFlexible hours$18 - $20 per hour
A leading radiology practice in Tennessee is seeking an experienced professional for healthcare billing and insurance verification roles. The position involves ensuring accurate insurance authorizations while providing excellent communication to patients and staff. The ...Hourly payRemote work$3,229 - $4,041 per month
...Education and Experience: Bachelor's degree. Substitution of Experience for Education: Qualifying full-time professional eligibility determination experience and/or a combination of para-professional experience as an Eligibility Assistant or a State contractor serving...Full timeFor contractorsWork at office- ...conducts prior authorization reviews for Georgia Fee-For-Service Medicaid members and out-of-state service requests, while meeting and... ...members as the Applied Behavior Analysis (ABA) Subject Matter Expert (SME) across multiple Alliant Health Group contracts. Coordinates...Contract workWork at office
- ...achieve it. Join us in empowering others to Live Well! Performance Incentive Opportunity In addition to competitive hourly pay, eligible Distribution Center team members who consistently exceed productivity expectations may earn additional performance based incentive...Hourly payPart timeNight shiftDay shift
$38.6k - $52.1k
...needed Provide support to other teams in Shared Services Serve as an SME for new hires Set up new STD claims in Ultera, CHESS and GCS... ...location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual...Temporary workLocal areaFlexible hours- ...adoption assistance and family benefits. Benefit options and eligibility vary by position, scheduled hours and location. Benefits are subject... ...billing tasks. Serves as the technical Subject Matter Expert (SME) for lower-level electricians, leads department orientations...Full timeShift work
$38.6k - $52.1k
...Provide support to other teams in Shared Services Serve as an SME for new hires Set up new STD claims in Ultera, CHESS and GCS... ...geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your...Temporary work$200k - $220k
...partnerships. The role will support the business strategy leads, SME’s, PEM members and Board to deliver that strategy. This role... ...salary range is between $200,000 - $220,000. This position is eligible to participate in an annual incentive program, and information on...Full timeTemporary workWork at officeRemote workWork from home$190.2k - $401k
...whitespace analysis, cross‑BU and cross‑DU opportunity tracking, multi‑SME pursuits, new‑logo targeting, upsell, retention risk, pipeline... ...and Accommodations page for more information: Candidate Eligibility: In compliance with federal law, all persons hired will be...Local areaWorldwide$37.14 per hour
...Applicants must be current residents of the State of Tennessee to be eligible for consideration. New hires will be required to report in... ...(RFIHI), funded through the Centers for Medicare and Medicaid Services (CMS) Rural Health Transformation (RHT) Program. Under...Contract workWork at officeMonday to FridayShift work$62 - $64 per hour
...of Duties Research and review appeals in TennCare’s Tennessee Eligibility Determination System (TEDS) database and make a valid factual... ...work effort Acquire and maintain a thorough understanding of Medicaid statutes, regulations, and policies. 25% of total work effort...Contract work- ...rendered. Key Responsibilities Certify and recertify hospice eligibility, ensuring timely compliance with Medicare and other... ...preferred. Current Medicare Provider Enrollment (PECOS) and Medicaid certification if required. Ability to travel 15-25% based on...Daily paidFull timePart timeLocal area
$130k - $140k
...right now. The mission of this organization is simple: turn the home into the engine of care. They serve medically complex Medicaid and Dual Eligible members, frail elderly individuals, and people with multiple chronic conditions who too often have no clinical pathway...Full timeLive inRemote workMonday to Friday- ...research discrepancies related to effective dates, preventing eligibility issues for members, providers, and MCOs. Communicate disenrollments... ...with the Public Health Emergency ending, redeterminations for Medicaid programs will be restarting at the end of March. This will...For contractors
- This position is incentive eligible. This Work from Home position requires that you live and will perform the duties of the position;... ...revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon...Temporary workWork at officeWork from homeFlexible hours
- ...management visits and hospice Face-to-Face (F2F) encounters for eligibility certification and recertification, and partner closely with... ...based on assessment findings. Ensure alignment with Medicare, Medicaid, and accrediting body requirements (e.g., ACHC). Notify appropriate...Daily paidFull timePart timeLocal area
- ...Line: Admin positions - will manage end-to-end hiring process for Benefits, Administrators, Medicaid, Analyst, Schedulers, etcetera Maintain and develop pipeline of eligible candidates for future open positions Qualify and/ or reject candidates based on interview feedback...Weekly payPermanent employmentContract workWork at officeLocal areaWork from home
- ...submit institutional claims (e.g., UB-04s/CMS-1450s) to Medicare, Medicaid, and all commercial insurance carriers via electronic... ...recovery. Conduct thorough pre‑billing audits to verify patient eligibility, authorization validity, and documentation completeness before...
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Medicaid Eligibility SME. Be the first to apply!



