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: