Remote Medicaid Certification Analyst - CMS & Compliance
$81.04k - $145kNTT Data Americas, Inc.
- Remote job
Req ID: 373298 NTT 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 Certification Analyst to join our team in Springfield, Illinois (US-IL), United States (US). NTT DATA is seeking a Medicaid Certification Analyst to support the State of Illinois in its strategic procurement efforts related to the modernization of its systems and services. This position plays a critical role in overseeing the administration, coordination, and compliance of CMS’ Streamlined Modular Certification (SMC) across the enterprise. The Certification Analyst will ensure that certification processes are consistent, accurate, and aligned with regulatory requirements as outlined by CMS. Job Responsibilities Include Support the State of Illinois through SMC process(es) at an enterprise level. Administer the activities of the certification process providing detailed direction to participants and coordinating with other departments. Initiate and execute improvements to existing certification processes and assist the state with new processes as needed. Interact professionally and timely with participants, partners, and other stakeholders including CMS. Prepare reporting on the status of certification efforts as directed by the state. Develop and maintain training tools, aids, and processes that state participants can utilize. Provide consistent interpretation of CMS SMC guidelines to the state and other participants. Effectively communicate with the client and other project stakeholders. Ensure compliance of federal regulations such as 42 CFR §433 Subpart C and 45 CFR §95 Subpart F Basic Qualifications Bachelor’s degree or associate degree with at least two (2) years of equivalent work experience. Minimum of 6 years’ business analysis skills and experience. Minimum of 4 years of direct experience with CMS certification (e.g., SMC, MEET, MECT). 3-5 years of experience in Medicaid or compliance, preferably within a public sector or healthcare environment. Familiarity with CMS SMC, CMS regulations, and APDs Strong analytical skills and attention to detail. Excellent verbal and written communication skills. Strong interpersonal skills to build client rapport and work collaboratively in a team environment. Preferred Skills Prior experience working with state governments Must be a team player and a consistent, dependable performer with an excellent work ethic, flexible "can-do" attitude, and a results-driven commitment to success Ability to handle ambiguity and change Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting pay range for this remote role is $81,040 - $145,000. 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 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. 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 ( #J-18808-Ljbffr NTT Data Americas, Inc.
$81.04k - $145k
NTT America, Inc. is seeking a Medicaid Certification Analyst in Springfield, Illinois to oversee compliance and coordination for CMS' certification processes. The ideal candidate will have a Bachelor’s degree and at least 6 years of applicable business analysis experience...Remote jobCms$81.04k - $145k
NTT DATA, Inc. is seeking a Medicaid Certification Analyst to join our team in... ...modernizing efforts by overseeing CMS’ Streamlined Modular Certification... ...processes, ensuring compliance and accuracy. The ideal candidate... .... The position offers a remote work option with a starting...Remote workCms- ...Medicaid/MMIS Subject Matter Expert Act as a Medicaid/MMIS SME across claims, eligibility... ..., and development teams Ensure compliance with CMS guidelines, HIPAA, and state Medicaid... ...initiatives Mentor business analysts and contribute to Agile delivery Requirements...Remote jobCms
$86.8k - $124k
Advisor Business Analyst - MMIS / Medicaid Pharmacy Location: Any city, DC, US,... ...operational impacts. Ensures compliance alignment by validating... ...and configuration conform to CMS guidance, state policy, and... ...expect in this role Fully remote options from Contiguous US...Remote workCmsFull timeFlexible hours$65k - $75k
...Specialist – Primary Care Location: Remote Employment Type: Full-Time... ...and external audits and ensure compliance with Centers for Medicare & Medicaid Services (CMS) guidelines Stay current on... ...ICD-10-CM and HCC coding ~ Certification such as CRC or CPC preferred...Remote workCmsFull time$49.93k - $97.36k
...Support functions to review compliance-based issues for benefit... ...to work independently in a remote environment. Ability to... ...Centers for Medicare & Medicaid Services (CMS) and the Affordable Care Act... ...(ACA). Medical Coding certification. To all current Molina...Remote workCmsWork experience placementWork at office$49.93k - $97.36k
...Support functions to review compliance-based issues for benefit... ...to work independently in a remote environment. Ability to... ...Centers for Medicare & Medicaid Services (CMS) and the Affordable Care Act... ...(ACA). Medical Coding certification. Molina Healthcare offers...Remote workCmsWork experience placementWork at office$24.6 - $32.8 per hour
...Centers for Medicare and Medicaid Services (CMS). SKILLS, KNOWLEDGE, EDUCATION... ...documentation and coding compliance with Federal, State and... ...activities to maintain their certification(s) and pertinent to areas... ...periods of time. 100% remote but if local may include some...Remote workCmsFull timeLocal areaShift workDay shift- ...Maximus is seeking an experienced Certification Lead to oversee the CMS certification process for a large-scale Medicaid IT implementation. The role entails managing certification... ...in CMS certification processes. This is a remote position with travel required to St. Louis,...Remote workCms
$71.4k - $135k
...seeking a Senior Business Analyst to join our team in Albany... ...contractors with obtaining CMS certification of the Medicaid Enterprise Systems (MES).... ...and subsystems to determine compliance with core CMS Federal... ...starting pay range for this remote role is $71,400 - $135,000...Remote workCmsTemporary workFor contractorsWork at officeLocal areaFlexible hours$86.8k - $124k
...Advisor Business Analyst - MMIS - Pharmacy... ...technical credentials and certifications while enjoying a... ...within MMIS Medicaid Management Information... ...impacts. Ensures compliance alignment by... ...configuration conform to CMS guidance, state... ...in this role Fully remote options from Contiguous...Remote workCmsFull timeFlexible hours$91.7k - $163.7k
...Reporting Business Analyst Optum Insight... ...bridge between CMS federal reporting... ...understanding how Medicaid programs are funded... ...regulatory compliance efforts. You'll... ...flexibility to work remotely* from anywhere within... ...work experience, certifications, etc. In addition...Remote workCmsMinimum wagePermanent employmentFull timeWork experience placementWork at officeLocal area- Maximus is seeking an experienced Certification Lead to manage the CMS certification process for a Medicaid IT implementation. This remote position requires significant interaction with stakeholders and entails frequent travel to the St. Louis area. Candidates should possess...Remote jobCms
- Maximus is seeking an experienced Certification Lead to manage the end-to-end CMS certification process for a Medicaid IT implementation. This role... ...Certification Readiness Plan, and ensuring compliance with CMS standards. The position is remote with travel to St. Louis....Remote jobCms
- Maximus is seeking an experienced Certification Lead to manage the CMS certification process for a large-scale Medicaid IT implementation. This remote role requires frequent travel to St.... ...preparing for reviews, and ensuring compliance with CMS standards. The ideal...Remote jobCmsFlexible hours
$86.3k - $118.7k
...Senior Project Management Analyst / Senior Program... ...Microsoft Access CMS Stars Program experience... ...experience, education, certifications, etc. $86,300 - $118... ...or both Medicare and Medicaid, achieve their best possible... ...action, in compliance with Section 503 of the...Remote workCmsBi-weekly payFull timeTemporary workApprenticeshipLive inWork at officeWork from homeHome office- ...the ICD‑10 code submitted to CMS for reimbursement. Interpret... ...auditing claims for Medicare and Medicaid plans. Extensive knowledge... ...required. Ability to work remotely without direct supervision.... ...mapping and hierarchy) License/Certification: Coding certification...Remote jobCmsFull timeTemporary workLocal area
- ...Senior Business Analyst (IT-Medicaid) Duration: 10+ months contract Location... ...Architecture (MITA), CMS Seven Conditions and Standards, Outcomes- Based Certification (OBC), 21st Century Cures Act... ...Corrective Action Plans for compliance reporting to federal entities...CmsContract workFor contractorsWork experience placementWork at office
- ...for children in Texas is seeking an HIM Coder Analyst II to accurately code medical records, ensuring compliance with ICD-10-CM and CPT guidelines. This role requires... ...at least one year of coding experience and certification in health information. Join a team committed to...Remote workCms
- ...records, assigning diagnosis codes, and ensuring compliance with CMS standards. Required qualifications include relevant certifications and 1-2 years of medical coding experience.... ...for professional growth. This is a fully remote role based in the United States. #J-18808-...Remote workCms
$80.6k - $172.4k
...Business System Analyst - Digital health... ...disease management, remote patient monitoring... ...network, IT, product, compliance, and vendor teams... ...compliance, SOC 2 certification, and... ..., Commercial, and Medicaid lines of business.... ...requirements including CMS telehealth and remote...Remote workCmsFull timeLocal area$73.7k - $117.92k
...seeking a Clinical Risk Management Analyst to enhance risk adjustment... ...education and analytics, ensuring CMS compliance, and collaborating with various teams... ...adjustment expertise, and relevant certifications. This position is remote-flexible and comes with a competitive...Remote jobCmsFlexible hours$27.02 - $41.85 per hour
...to support Medicare Advantage programs. This remote position requires proficiency in HCC coding, in-depth knowledge of CMS guidelines, and 3 years of coding experience... ...recommendations. Candidates should hold certifications such as CPC, CRC, and CCS. Attention to detail...Remote jobCmsHourly pay- ...Manager – Consultant (Medicaid Systems Operations)... ...3 days onsite, 2 days remote Duration: 12 months Interview... ...and vendors. Ensure compliance with security and regulatory standards (CMS, SSA, etc.). Act as... ...Confluence, etc.). AWS Cloud Certifications. Strong presentation...Remote workCmsContract workRelocation
$49.93k - $97.36k
...applies this knowledge to ensure compliance and advocates for necessary... ...environment, preferably in a Medicaid environment, or equivalent... ...standards, such as HIPAA and CMS guidelines. Developed understanding... ...‑care delivery system. Certification in conflict resolution or...Remote jobCmsWork experience placementWork at office- ...Business Analyst (AI/Healthcare/FIHR/HIPAA)... ...Years Location: Remote Department: Strategy... ...in regulatory compliance, customer journey mapping... ...regulatory mandates (e.g., CMS, HIPAA) and translate... ...and Visio. Agile certification (e.g., PMI-ACP, SAFe,...Remote workCms
- ...seeking a highly experienced Data Analyst to join our Enterprise Data... ...experience working with State Medicaid and CHIP agencies or... ...payer • Basic understanding of CMS reporting requirements for Medicaid... ...tools such as Tableau or Power BI. This is a remote position....Remote workCmsPermanent employment
- ...Description: 100% Remote but prefer local candidates (Pittsburgh... ...on resume Business Analyst CMS ONC Interoperability Job Summary... ...engineering, architecture, compliance, and external customers. This... ...interoperability platforms. Certifications in business analysis, data engineering...Remote workCmsLocal area2 days per week3 days per week
$97.97k - $124.2k
...Functional Analyst - Principle Our work is looking for a Functional Analyst - Principle... ...support the Centers for Medicare and Medicaid Services (CMS). At GDIT, our people are at the... ...communicate with team members while working remotely Required Skills: ~ Bachelors...Remote workCmsTemporary workFlexible hours- ...executive-level oversight of Compliance, Bank Secrecy Act / Anti-Money... ...Management System (CMS), ensuring it is appropriately... ...) preferred. Professional certifications such as CRCM, CAMS, CERP, or... ...a hybrid schedule, with a mix of in-office and remote work....Remote workCmsWork at officeLocal area
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