Posted: Jan 8, 2026
Contract Opportunity Location: Remote (preferred PST hours, Sacramento, CA) Duration: 12 months (Contract) We re hiring a seasoned consultant to lead CMS Interoperability & Prior Authorization compliance within Medicaid/MMIS programs. This is a high-visibility, high-pressure role where you ll engage directly with state executives, CMS liaisons, and technology vendors . This isn t a traditional BA role you ll be the trusted advisor and strategist , helping leadership navigate mandates, secure stakeholder buy-in, and bridge the gap between program strategy and technical implementation . What You ll Do Lead executive and stakeholder sessions with state leadership, CMS, and vendors. Drive gap assessments & compliance analysis for CMS Interoperability & PA Final Rule. Provide executive-level insights and roadmaps to guide Medicaid/MMIS modernization. Collaborate across business, clinical, and IT teams to define requirements and system impacts. Interpret HL7 FHIR & ASC X12 standards and advise on adoption strategies. Act as the glue between state leadership and vendors to keep initiatives on track. What We re Looking For 8+ years in healthcare IT consulting ( Medicaid/MMIS required ). Strong knowledge of CMS Interoperability & Prior Authorization mandates . Experience working with state executives, CMS, and tough stakeholders in complex programs. Strong command of HL7 FHIR, ASC X12, and Medicaid data exchange . Leadership presence with the ability to thrive in high-pressure environments . Hands-on experience with Medicaid Enterprise Systems (MMIS) modernization. Strong knowledge of FHIR APIs, HL7 standards, and interoperability frameworks . Experience with EDI transactions (X12 278, 834, 837, 835, etc.) in Medicaid/Payer systems. Background in Prior Authorization automation, clinical workflows, or policy implementation. Experience designing or advising on API-led integration strategies for healthcare programs. Familiarity with MITA 4.0 and state Medicaid compliance initiatives. If you re a strategic consultant who can manage tough clients, complex dynamics, and executive-level conversations while guiding technical teams toward compliance success we want to talk to you. Apply today to join this remote, 12-month contract supporting California s Medicaid modernization initiatives. Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.
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