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Description

Our client, a leading healthcare organization, is seeking an experienced Medicaid Enrollment & Eligibility Consultant for a fully remote, contract-based opportunity. This role will play a key part in evaluating and optimizing Medicaid enrollment and eligibility operations, ensuring compliance, efficiency, and accuracy across systems and processes.

Key Responsibilities:

+ Conduct comprehensive assessments of current Medicaid Enrollment and Eligibility operations, including workflows, staffing models, and system configuration.

+ Evaluate the full enrollment lifecycle to identify operational gaps, inefficiencies, and potential compliance risks.

+ Analyze key performance metrics and recommend process improvements to improve accuracy, timeliness, and regulatory compliance.

+ Assess current use and configuration of the QNXT system, focusing on eligibility and enrollment modules.

+ Collaborate with business and IT stakeholders to propose system enhancements or workflow changes.

+ Provide expert guidance on Medicaid regulatory requirements that impact enrollment and eligibility processes.

+ Support the development and refinement of policies, standard operating procedures (SOPs), job aids, and training materials.

+ Assist in audit preparation, compliance reviews, and regulatory reporting as needed.

+ Facilitate knowledge transfer and promote best practices among internal teams and partners.

Requirements

+ Minimum 5 years of experience in Medicaid enrollment and eligibility functions within a health plan or managed care organization.

+ Deep understanding of the Medicaid enrollment lifecycle, including eligibility verification, member enrollment, reconciliation, and reporting.

+ Strong working knowledge of state Medicaid regulations and CMS requirements.

+ Proven hands-on experience with the QNXT system, particularly in the eligibility and enrollment components.

+ Excellent analytical, communication, and stakeholder engagement skills.

+ Ability to work independently in a fast-paced, fully remote environment.

Robert Half is the world’s first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles.

Robert Half works to put you in the best position to succeed. We provide access to top jobs, competitive compensation and benefits, and free online training. Stay on top of every opportunity - whenever you choose - even on the go. Download the Robert Half app (https://www.roberthalf.com/us/en/mobile-app) and get 1-tap apply, notifications of AI-matched jobs, and much more.

Robert Half will consider for employment qualified applicants with arrest or conviction records in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information.

• 2025 Robert Half. An Equal Opportunity Employer. M/F/Disability/Veterans. By clicking “Apply Now,” you’re agreeing to Robert Half’s Terms of Use (https://www.roberthalf.com/us/en/terms) .