Medicaid Financial and MES implementation Technical Lead

About Us The North Carolina Department of Health and Human Services (DHHS) is one of the largest, most complex agencies in the state, and has approximately 17,000 employees. It is responsible for ensuring the health, safety, and well-being of all North Carolinians, providing human service needs for special populations including individuals who are deaf, blind, developmentally disabled, and mentally ill, and helping poor North Carolinians achieve economic independence.

Description of Work We are seeking a highly experienced and technically proficient MES Implementation Technical Lead to join our team at Health & Human Services. This role will be instrumental in guiding the technical aspects of our Medicaid Enterprise System (MES) implementations, focusing specifically on Medicaid Claims and Encounters modules and their integration, ensuring compliance with federal and state regulations, and driving successful project outcomes.

The primary purpose of this position is to work with the different Medicaid Enterprise System modules and Division multi-payers (NCTracks and EPS) on process improvements, implementing new requirements, and analyzing current production results. This position will serve as a liaison between the Division business owners and the vendor IT to improve productivity. This position must be able to analyze, forecast, and trend complex data.

In addition, it will present the analysis and interpretation for operational business review. This position must support short and long term operational/strategic business activities by recommending business process solutions through research and analysis of data. This resource will be responsible for verifying, validating, overseeing, and maintaining technical application solutions for Tribal Care and Managed Care Claims and Encounter transactions in EPS and NCTracks multi-payer projects.

Interaction with a broad range of clients and/or technology needed to support employees and requires strong communications skills and ability to use a wide range of technical resources for providing technical support. Position will work with internal staff, external vendors and state level services. This position will provide advanced level support for a broad range of technologies.

• Lead the technical design, development, and implementation of Medicaid financial modules within the MES, including claims processing, encounter data, provider payments, and financial reporting.
• Provide expert technical guidance and oversight to development teams, ensuring adherence to architectural standards, best practices, and security protocols.
• Collaborate with business stakeholders, program managers, and vendors to translate complex business requirements into robust and scalable technical solutions.
• Oversee the integration of the MES financial components with other state systems, third-party applications, and federal reporting interfaces.
• Conduct technical reviews of system designs, code, and test plans to ensure quality, performance, and maintainability.
• Troubleshoot and resolve complex technical issues related to Medicaid financial processes and MES functionality.
• Develop and maintain comprehensive technical documentation, including architecture diagrams, design specifications, and operational procedures.
• Stay abreast of federal and state Medicaid regulations, industry standards, and emerging technologies to ensure MES compliance and optimization.
• Mentor and provide technical leadership to junior team members.

Salary Grade Range: $87,617.00 - $ Recruitment Range: $87,617.00 - $

Candidates now meet the minimum qualifications of a position if they meet the minimum education and experience listed on the vacancy announcement. The Knowledge, Skills, and Abilities (KSAs)/ Management Preferences are not required. Applicants who possess the following skills are preferred:

• Progressive experience in IT, specifically focused on Medicaid Claims, Encounters, financial systems and MES implementations and understanding of Medicaid program regulations (e.g., CMS 7 Standards and Conditions, T-MSIS) and financial operations.
• Proven experience leading technical teams in large-scale system integration and implementation projects.
• Excellent analytical,…