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Medicaid Jobs (NOW HIRING)

Isaac School District

Medicaid Facilitator

Phoenix, AZ · On-site

ASAP Job Summary The Medicaid Facilitator manages and coordinates all aspects of the Medicaid program for the elementary school district. Key objectives include ensuring compliance with state and ...

Family First Firm

Medicaid Specialist

Winter Park, FL · On-site

Job Summary Our Medicaid Specialists serve as vital contributors to the Medicaid planning team, focusing on foundational casework, client support, and documentation management. This role is ideal for ...

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Medicaid Biller

Lafayette, LA · On-site

$16/hr

The Medicaid Biller is responsible for accurately processing and submitting claims to Medicaid, ensuring compliance with relevant regulations and codes. This role requires a detail-oriented ...

Isaac School District

Medicaid Facilitator

Phoenix, AZ · On-site

ASAP Job Summary The Medicaid Facilitator manages and coordinates all aspects of the Medicaid program for the elementary school district. Key objectives include ensuring compliance with state and ...

Memorial Health

Medicaid Specialist

Springfield, IL · Remote

$18.34 - $28.42/hr

Ensures compliance with Medicaid guidelines and MMC organizational policies. Embodies the Memorial Health System Performance Excellence Standards of Safety, Courtesy, Quality, and Efficiency that ...

Memorial Health

Medicaid Specialist

Springfield, IL · Remote

$18.34 - $28.42/hr

Ensures compliance with Medicaid guidelines and MMC organizational policies. Embodies the Memorial Health System Performance Excellence Standards of Safety, Courtesy, Quality, and Efficiency that ...

Memorial Health

Medicaid Specialist

Springfield, IL · On-site

$18.34 - $28.42/hr

Ensures compliance with Medicaid guidelines and MMC organizational policies. Embodies the Memorial Health System Performance Excellence Standards of Safety, Courtesy, Quality, and Efficiency that ...

Chesterfield

Medicaid Specialist

Central, LA · On-site

Coordinates and manages all components of Medicaid administrative billing and reimbursement for services. Supervises support and professional staff assigned to assist with the implementation of ...

Hire Solutions

Medicaid Pender

Lakewood, NJ · On-site

Medicaid Pender Position Summary: We are seeking a responsible, organized, and proactive individual to manage Medicaid accounts for assigned nursing home facilities. This role requires strong ...

Americare

Medicaid Coordinator

Manhattan, NY · On-site

The Medicaid Coordinator plays a critical role in supporting organizational operations and patient access to care by managing Medicaid eligibility, enrollment, and reimbursement processes. This ...

VIP Care Management

Medicaid Specialist

Lantana, FL · On-site

$40K - $50K/yr

Director of Operations What You'll Do · Lead Medicaid intake meetings with new clients (in person or virtual). · Collect and organize all required supporting documents. · Prepare and submit ...

Americare

Medicaid Coordinator

New York, NY · On-site

The Medicaid Coordinator plays a critical role in supporting organizational operations and patient access to care by managing Medicaid eligibility, enrollment, and reimbursement processes. This ...

Miller Law Office, PLLC

Medicaid Specialist

Plano, TX

$65K/yr

The Medicaid Specialist manages the full qualification process -- from initial eligibility analysis to application submission and annual renewals -- so families get the benefits they need, and our ...

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All JobsMedicaid Jobs

Medicaid information

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$15

$27

$42

How much do medicaid jobs pay per hour?

As of Jul 7, 2026, the average hourly pay for medicaid in the United States is $27.85, according to ZipRecruiter salary data. Most workers in this role earn between $17.31 and $32.69 per hour, depending on experience, location, and employer.

What are Medicaid jobs?

Medicaid jobs typically refer to positions that involve administering, managing, or supporting the Medicaid program, which provides health coverage to eligible low-income individuals and families in the United States. These jobs can include case managers, eligibility specialists, policy analysts, healthcare providers, and administrative staff who work for state agencies, healthcare organizations, or managed care companies. Professionals in these roles help applicants access benefits, ensure compliance with federal and state regulations, and support the delivery of healthcare services to Medicaid recipients.

What are the key skills and qualifications needed to thrive as a Medicaid Specialist, and why are they important?

To succeed as a Medicaid Specialist, you need a strong understanding of healthcare regulations, Medicaid eligibility criteria, and case management, typically supported by a degree in social work, public health, or a related field. Familiarity with Medicaid management information systems (MMIS), electronic health records (EHRs), and relevant billing or compliance software is often required. Excellent communication, problem-solving, and attention to detail are essential soft skills for effectively serving clients and navigating complex regulations. These competencies ensure accurate eligibility determinations, compliance with policies, and support for vulnerable populations accessing care.

What is the difference between Medicaid vs Medical Assistant?

AspectMedicaidMedical Assistant
CredentialsNone required; eligibility based on incomePost-secondary education, certification often required
Work EnvironmentGovernment programs, clinics, hospitalsDoctor's offices, clinics, hospitals
Employer & IndustryGovernment-funded health insurance programHealthcare providers, clinics

Medicaid is a government health insurance program for eligible individuals, while a Medical Assistant is a healthcare professional providing clinical and administrative support in medical settings. Medicaid focuses on funding and eligibility, whereas Medical Assistants deliver direct patient care and support healthcare operations.

What are some common challenges faced by Medicaid case managers, and how can applicants prepare for them?

Medicaid case managers often navigate complex regulations and high caseloads, making time management and attention to detail essential skills. They regularly interact with clients who may have urgent needs or face barriers to accessing care, which can be emotionally demanding. Collaborating with healthcare providers, social workers, and government agencies is a daily part of the role, so strong communication and problem-solving abilities are critical. Applicants can prepare by familiarizing themselves with Medicaid policies in their state, developing organizational strategies, and cultivating empathy to support diverse populations effectively.
More about Medicaid jobs
What cities are hiring for Medicaid jobs? Cities with the most Medicaid job openings:
What are the most commonly searched types of Medicaid jobs? The most popular types of Medicaid jobs are:
What states have the most Medicaid jobs? States with the most job openings for Medicaid jobs include:
What job categories do people searching Medicaid jobs look for? The top searched job categories for Medicaid jobs are:
Medicaid jobs near you
Medicaid SME - MS - Medicaid

Medicaid SME - MS - Medicaid

HCL Global Systems

Jackson, MS • On-site

Other

Posted 28 days ago

Job description

Description:
  • The Medicaid SME will provide subject matter expertise related to Medicaid program data, policies, and operational workflows to support the successful implementation and operationalization of the Program Integrity (PI) tool. The SME will collaborate with technical teams, program staff, vendors, and project leadership to ensure the PI solution effectively leverages Medicaid data to detect, prevent, and investigate fraud, waste, and abuse.

Key Responsibilities:
  • Data Domain Expertise - Provide expert guidance related to the structure, relationships, and usage of Medicaid data domains, including:

Member Data:
  • Eligibility and enrollment data
  • Demographic and coverage information
  • Managed care enrollment and attribution
  • Member identifiers and cross-system matching

Provider Data:
  • Provider enrollment and credentialing
  • Provider taxonomy and specialty classifications
  • Provider affiliations and group relationships
  • National Provider Identifier (NPI) and provider registry integration

Claims Data:
  • Professional, institutional, and pharmacy claims
  • Claim lifecycle and adjudication processes
  • Service codes (CPT, HCPCS, ICD, DRG)
  • Payment and encounter processing
  • Claims adjustments, voids, and resubmissions

Managed Care Data:
  • Managed Care Organization (MCO) encounter data
  • Capitation payments
  • Managed care reporting requirements
  • Encounter-to-claim mapping and validation

Program Integrity Support:
  • Advising on data requirements for fraud, waste, and abuse detection
  • Assisting with data mapping and data model validation for the PI tool
  • Supporting development of analytics, rules, and investigative workflows
  • Identifying data quality issues and remediation strategies
  • Helping define use cases and investigative scenarios
  • Ensuring accurate interpretation of Medicaid policy and program rules within the tool

Implementation Support:
  • Collaborating with system integrators and vendors on data ingestion and transformation
  • Supporting data validation, testing, and reconciliation
  • Participating in requirements gathering and design sessions
  • Providing business context for technical teams
  • Reviewing system outputs for accuracy and relevance
  • Supporting User Acceptance Testing (UAT)

Stakeholder Collaboration:
  • Program Integrity leadership
  • Data analytics teams
  • Medicaid program staff
  • IT and data architecture teams
  • System implementation vendors
  • Managed Care oversight teams

Work Products:
  • Medicaid data domain documentation validation
  • Data mapping and data dictionary validation
  • Program Integrity use cases and business rules validation
  • Data quality assessments and recommendations
  • Support documentation for system configuration validation
  • UAT participation and validation feedback
  • Implementation support reports and findings validation

Note:
  • Applicants who do not meet all of the required skills/experience minimums may not be considered further.
  • The awarded applicant will be required to execute a Business Associate Agreement (BAA) with DOM.
  • The period of performance will be for one-year intervals with the ability to renew for up to five (5) years based on mutual agreement of the parties.

Required Skills/Experience
Provide the minimum required skills and/or experience the contractor must possess to qualify for this position. These requirements will be transferred to the Score Sheet and candidates without these requirements reflected on their resume will NOT be presented to the manager for consideration.
The Medicaid SME must possess:
  • Minimum of 15 years of experience working with Medicaid program data and operations

Demonstrated expertise in the following Medicaid data domains:
  • Member/Eligibility data
  • Provider enrollment data
  • Claims and encounter data
  • Managed care program data
  • Experience working with Gainwell Medicaid Management Information Systems (MMIS) or successor platforms
  • Strong understanding of Medicaid program policies and regulatory requirements
  • Experience supporting large system implementations or modernization projects
  • Ability to communicate complex Medicaid data concepts to technical and non-technical stakeholders

Preferred / Not Required:
Provide any skills/experience that would be helpful for the candidate to possess but not required. Examples: Previous supervisory experience, WebLogic experience helpful, etc.
  • Experience implementing and managing Provider Enrollment systems
  • Experience implementing claims systems and managing claims data
  • Familiarity with CMS reporting and compliance requirements
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About HCL Global Systems

Sourced by ZipRecruiter

HCL Global Systems is One of the Best IT Consulting Firm specialized in Application Development, Quality Testing, IT Courses Training, Staffing and Recruitment services. With wide range of experience, We are confident in our ability to help our Customers grow and improve their businesses. More than likely, regardless of the nature and scope of the problem, Our dedicated Team of Professionals can help you to achieve a cost effective business solution.

Industry

It services

Company size

1,001 - 5,000 Employees

Headquarters location

Farmington Hills, MI, US

Year founded

2005

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