Healthcare Claims Technology Consultant
Company: VirtualVocations
Location: Bell Gardens
Posted on: May 3, 2025
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Job Description:
A company is looking for a Senior Manager/ Associate Director -
Technology Consulting (Healthcare Claims).
Key Responsibilities
Analyze Medicare and Medicaid processes, focusing on claims
management, and provide insights on business procedures and
regulations
Evaluate and recommend AI and analytics use cases to address client
challenges related to complex business logic and workflows
Educate project teams on Medicare/Medicaid concepts and assess
project deliverables for alignment with industry best practices
Required Qualifications
12-15 years of domain consulting experience with a strong Data
Engineering background
Extensive understanding of the US healthcare system and
Medicare/Medicaid regulations
Good understanding of plan offerings and eligibility for Medicare
and Medicaid programs
Knowledge of CMS guidelines, ACA, and HIPAA regulations
Masters/Bachelor of Science/Engineering or MBA preferred;
healthcare certifications are a plus
Keywords: VirtualVocations, Altadena , Healthcare Claims Technology Consultant, Healthcare , Bell Gardens, California
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