Senior Business Transformation Consultant, Medicaid Management Information Systems

What you'll do

• Serve as the primary subject matter expert on California Medicaid policies, MMIS applications, and federal regulatory requirements.
• Translate complex Medicaid business requirements into clear technical specifications and implementation roadmaps for digital transformation.
• Act as the primary consulting liaison between clinical, operational, and technical stakeholders to align on innovation priorities.
• Evaluate AI and automation initiatives against Medicaid compliance requirements, operational feasibility, and program impact.
• Provide technical guidance to teams regarding Medicaid-specific business constraints, data requirements, and HIPAA compliance.
• Offer evidence-based recommendations on prioritization, resource allocation, and success metrics for the CAMMIS Innovation Program.
• Advise on strategic decisions related to AWS cloud transformation and legacy MMIS application enhancements.

What we're looking for

• Experience in Medicaid Management Information Systems (MMIS), healthcare IT systems, and managed care environments.
• Deep expertise in Medicaid policies, compliance requirements, and federal healthcare policy mandates.
• Knowledge of HIPAA compliance, data governance, and security requirements in Medicaid environments.
• Experience translating healthcare policies into technical specifications and implementation roadmaps.
• Advanced analytical skills to assess business/IT portfolios and develop value-driven recommendations.
• Experience advising stakeholders on AI implementation challenges including data quality and bias mitigation.
• Proven understanding of AI/GenAI applications in healthcare and government settings (preferred).
• Bachelor's Degree.