Fiscal Agent Operations Leader - MMIS
Our Deloitte AI & Engineering team to transform technology platforms, drive innovation, and help make a significant impact on our clients' success. You'll work alongside talented professionals reimagining and reengineering operations and processes that are critical to businesses. Your contributions can help clients improve financial performance, accelerate new digital ventures, and fuel growth through innovation.
Work You'll Do
- Identify, qualify, and drive new Medicaid Management Information System (MMIS) fiscal agent opportunities by leading capture planning, shaping win themes, and developing proposal solution narratives and client-ready presentations. Act as a Subject Matter expert in strategic pursuits, applying deep expertise in claims processing and financial operations to improve win likelihood.
- Direct day-to-day Medicaid claims processing and financial operations, setting performance expectations and ensuring readiness for go-lives and operational transitions. Establish and monitor compliance, controls, and service delivery metrics to ensure consistent execution and measurable business outcomes.
- Develop and sustain relationships with state agency leaders and key stakeholders through regular touchpoints and transparent communication. Lead requirements workshops, executive updates, and issue triage/resolution to maintain alignment, manage expectations, and drive successful outcomes.
- Lead cross-functional, multi-location teams across claims processing, payment management, and modernization workstreams. Assign work, manage capacity and dependencies, and drive milestone-based delivery through disciplined planning, status reporting, and escalation when needed.
- Define modernization and modularity roadmaps for MMIS capabilities, translating current-state constraints into future-state designs and phased implementation plans. Promote interoperability and continuous improvement by driving operational change management suited to high-volume public program environments.
- Implement and enforce change control and incident/problem management routines, including root cause analysis and corrective action tracking. Proactively identify delivery and production risks, execute mitigations, and reduce recurring issues and operational surprises through controls and trend-based improvements.
The Team
Deloitte's Government & Public Services (GPS) practice - our people, ideas, technology and outcomes - is designed for impact. Serving federal, state, & local government clients as well as public higher education institutions, our team of professionals brings fresh perspective to help clients anticipate disruption, reimagine the possible, and fulfill their mission promise.
Our Industry Solutions clients seek verticalized solutions that transform how they sell products, deliver services, generate growth, and fulfill mission-critical operations. The Industry Solutions offering delivers integrated business expertise with repeatable scaled technology solutions that are specifically engineered for each sector's IndustryAdvantageTM.
Qualifications
Required:
- Bachelor's degree.
- Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future.
- 10 + years of expertise in Medicaid claims processing, HIPAA X12 transaction sets, MITA frameworks, and SDLC methodologies (Waterfall, Kanban, Scrum Agile).
- 5+ years of hands-on experience with MMIS design, development, validation, and maintenance across multiple states.
- 5+ years of experience in business development for Medicaid fiscal agent operations and MMIS takeover projects.
- 3+ years of leadership experience managing large project teams and overseeing operational delivery at extreme scale (Millions of records processed weekly)
- Ability to travel 30-50%, on average, based on the work you do and the clients and industries/sectors you serve.
Preferred:
- Masters Degree preferred.
The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled. At Deloitte, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $167,300 to $278,900.
You may also be eligible to participate in a discretionary annual incentive program, subject to the rules governing the program, whereby an award, if any, depends on various factors, including, without limitation, individual and organizational performance.
Information for applicants with a need for accommodation: https://www2.deloitte.com/us/en/pages/careers/articles/join-deloitte-assistance-for-disabled-applicants.html
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