About this role
Summary
Seeking a highly skilled Reference SME with strong expertise in Medicaid Reference Configuration, BPA setup, Oracle, C, and Pro*C technologies. The candidate will manage configuration and maintenance of Benefit Plans, Assignment Plans, Provider Contracts, Reference Tables, Rule Metadata, and BPA configuration components used in claims adjudication.The role requires deep understanding of Medicaid reference data structures and how reference configuration impacts claims, provider enrollment, reimbursement, audits, and policy administration.
Your role in our mission
Required Technical Skills
Programming Skills
- C Programming
- Pro*C
- Oracle SQL
- PL/SQL
- Unix/Linux Shell Scripting
- Batch Processing
Reference/BPA Skills
- BPA Configuration
- Reference Data Management
- Rule Metadata
- Rule Variables
- Benefit Classifications
- Rule Sheets
- Release Management
- Provider Contracts
- Benefit Plan Hierarchies
- Assignment Plan Hierarchies
What we're looking for
Ideal Candidate Profile
Reference SME (9+ Years)
60% Technical | 40% Functional
- Strong Oracle, C, Pro*C expertise
- Deep BPA configuration knowledge
- Provider Contract and Benefit Plan maintenance experience
- Rule Metadata and Rule Sheet management
- Configuration governance and release management expertise
- Strong troubleshooting and production support capability
What you should expect in this role
- Remote Opportunities