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MMIS Business Subject Matter Expert (SME)

MMIS Business Subject Matter Expert (SME)

Trigyn Technologies IncWaterbury, VT, US
11 hours ago
Job type
  • Full-time
Job description

Immediate long-term contract opportunity for MMIS Business Subject Matter Expert with direct client in Waterbury, VT. Trigyn Technologies is seeking a highly experienced MMIS Business Subject Matter Expert (SME). This role provides deep hands-on expertise to ensure modernization initiatives align with real-world business operations, policies, and compliance requirements. The SME will work directly with business teams in MMIS, advising on business workflows, program policies, and operational impacts. Role Overview : This role focuses on tactical execution, helping business teams define requirements, develop business rules, validate system changes, and ensure that modernization efforts integrate smoothly into daily operations. SME’s play a critical role in bridging business needs with technology solutions, ensuring that transformation efforts are practical, scalable, and user centered. Key Responsibilities

  • Provide deep expertise in business processes, program policies, and procedures to ensure project alignment with operational goals.
  • Advise on business requirements, workflows, procedures, and policies to support effective implementation of modernization initiatives.
  • Collaborate with State business teams, leadership, and other subject matter experts to guide informed decision-making and ensure project outcomes align with business goals and program policies.
  • Offer guidance on policy and procedures to maintain compliance with federal and state regulations while supporting business objectives.
  • Assess the impact of new processes, systems, or changes on business operations and recommend actionable steps for seamless integration.
  • Support the development of business artifacts, including business rules, process documentation, and operational procedures, to enhance project outcomes.
  • Act as a bridge between business and technology teams, ensuring modernization efforts align with operational needs and user requirements.
  • Identify potential risks and roadblocks, working proactively with teams to develop mitigation strategies and ensure smooth execution.
  • Advise on operationalizing and aligning business processes with project goals, ensuring solutions are scalable, sustainable, and meet long-term program needs.
  • Mentor and transfer knowledge to State teams, ensuring they have the capacity to navigate and implement modernization efforts successfully.
  • Facilitate validation of business requirements, ensuring solutions meet end-user needs and policy objectives.
  • Support efforts to measure success, track key milestones, and ensure accountability for modernization initiatives.
  • Provide strategic insights into future-state business development, advising on long-term program sustainability and continuous improvement. Qualifications & Experience
  • Bachelor’s degree in a relevant field (public health, public policy, healthcare administration, business, IT) or equivalent experience.
  • Extensive experience in MMIS : Claims processing, provider enrollment, prior authorization, pharmacy benefit management, care management, appeals, and third-party liability.
  • Strong understanding of Medicaid operations, policy, and business domains.
  • Proven ability to translate complex policy and operational requirements into business rules and process documentation.
  • Excellent communication, stakeholder engagement, analytical, and documentation skills.
  • Ability to work onsite in Waterbury, VT, on a hybrid basis, at the request of the State. TRIGYN IS AN EQUAL OPPORTUNITY EMPLOYER About Trigyn : Trigyn is an IT Services Company that has been in business for 30 years with more than 1,500 resources deployed today. Trigyn is ISO 9001 : 2015, ISO 27001 : 2013 (ISMS) and CMMI Level 5 Certified. Trigyn is an E-Verify® Employer.
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Subject Matter Expert • Waterbury, VT, US

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