Eligibility Rules and Policy Configurator Specialist - Remote

Overview

The Eligibility Rules & Policy Configurator Specialist plays a key role in transforming complex state and federal Medicaid policies into system-configured eligibility rules that ensure accurate and compliant benefit determinations.

In Short

• Translate Medicaid policy into logical, rules-based configurations.
• Configure and test eligibility determinations and renewals.
• Validate rule accuracy and behavior with policy and technical teams.
• Document configuration designs and test results.
• Support post-implementation maintenance and enhancements.
• Participate in cross-functional working sessions.
• Remote contract role with occasional travel.
• Work at the intersection of policy and technology.
• Shape how critical benefits are delivered to millions.
• Improve access to healthcare and human services.

Requirements

• 4–8 years of experience with Integrated Eligibility Systems (IES).
• Experience configuring business or eligibility rules.
• Hands-on experience translating Medicaid or Human Services policy.
• Strong analytical, testing, and problem-solving skills.
• Excellent documentation and collaboration skills.
• Bachelor’s degree in Public Policy, Computer Science, or related field.
• Familiarity with state or federal Medicaid policy frameworks preferred.
• Experience with consulting or systems integration teams preferred.
• Understanding of eligibility determination processes preferred.

Benefits

• Opportunity to shape critical benefits delivery.
• Work remotely with a flexible schedule.
• Collaborate with experts in policy and technology.
• Engage in impactful work improving access to services.