ForHealth Consulting at UMass Chan Medical School
Medicaid Eligibility Consultant II
ForHealth Consulting at UMass Chan Medical School, Shrewsbury, Massachusetts, us, 01546
Job Summary
Under the general direction of the Senior Associate or designee, the Medicaid Eligibility Consultant II will assist in the development of contracts with state agencies; both in and out of state. The Consultant should be an insightful, detail-oriented professional with Medicaid-related experience, excellent analytical and organizing skills who is able to apply that skill set to support both Medicaid Eligibility and Program Integrity Initiatives as well as the design, development and implementation of Medicaid eligibility systems. Responsibilities
Conduct complex analysis to support Medicaid eligibility and program integrity projects in and out of state. Perform research and development analysis relevant to Medicaid eligibility and program integrity revenue management/cost savings projects. Contribute to the development of program and project expansion plans. Contribute to the development of presentations and marketing materials to clients. Provide on-site support to senior staff during client visits and meetings. Participate in the development of agreements between public entities and the University. Participate in the development of Medicaid systems on behalf of the client Medicaid agency, including: Support as an SME in Medicaid eligibility regulations, operations, and processes to design, develop and implement changes to Medicaid MAGI and non-MAGI eligibility systems. Present Medicaid agency business needs and strategic vision in system development activities. Work with multi-agency workgroups to develop a common eligibility application. Meet with upstream and downstream stakeholders to assess needs and provide solutions. Attend business and system design sessions. Review, provide feedback on and approve business system design requirements. Attend scheduled meetings virtually and onsite. Assist with testing and resolution of system defects. Support procurement processes such as RFI and RFP development. Contribute to project forecasting and complete assigned cost analysis tasks to support financial planning and savings initiatives. Present to staff regarding success and merits of initiatives. Research, develop, and prepare work and implementation plans to support projects and initiatives, completing assigned projects from start to finish. Qualifications
Bachelor’s Degree or equivalent in business, health policy, social service, or public administration. 3 to 5 years of experience in a business related field. Extensive and in-depth knowledge of Medicaid policies, programs and procedures with ability to integrate this knowledge into new and existing IT systems. Familiarity working with complex technical, systems and/or program issues affecting Medicaid and its services to members. Strong verbal and written communication skills. Knowledge of state and federal regulations as they apply to public assistance programs. Proficiency in Microsoft Word, Excel and PowerPoint. Demonstrated project management skills. Ability to travel to client and/or off-site locations weekly. The University of Massachusetts Chan Medical School welcomes all qualified applicants and complies with all state and federal anti-discrimination laws.
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Under the general direction of the Senior Associate or designee, the Medicaid Eligibility Consultant II will assist in the development of contracts with state agencies; both in and out of state. The Consultant should be an insightful, detail-oriented professional with Medicaid-related experience, excellent analytical and organizing skills who is able to apply that skill set to support both Medicaid Eligibility and Program Integrity Initiatives as well as the design, development and implementation of Medicaid eligibility systems. Responsibilities
Conduct complex analysis to support Medicaid eligibility and program integrity projects in and out of state. Perform research and development analysis relevant to Medicaid eligibility and program integrity revenue management/cost savings projects. Contribute to the development of program and project expansion plans. Contribute to the development of presentations and marketing materials to clients. Provide on-site support to senior staff during client visits and meetings. Participate in the development of agreements between public entities and the University. Participate in the development of Medicaid systems on behalf of the client Medicaid agency, including: Support as an SME in Medicaid eligibility regulations, operations, and processes to design, develop and implement changes to Medicaid MAGI and non-MAGI eligibility systems. Present Medicaid agency business needs and strategic vision in system development activities. Work with multi-agency workgroups to develop a common eligibility application. Meet with upstream and downstream stakeholders to assess needs and provide solutions. Attend business and system design sessions. Review, provide feedback on and approve business system design requirements. Attend scheduled meetings virtually and onsite. Assist with testing and resolution of system defects. Support procurement processes such as RFI and RFP development. Contribute to project forecasting and complete assigned cost analysis tasks to support financial planning and savings initiatives. Present to staff regarding success and merits of initiatives. Research, develop, and prepare work and implementation plans to support projects and initiatives, completing assigned projects from start to finish. Qualifications
Bachelor’s Degree or equivalent in business, health policy, social service, or public administration. 3 to 5 years of experience in a business related field. Extensive and in-depth knowledge of Medicaid policies, programs and procedures with ability to integrate this knowledge into new and existing IT systems. Familiarity working with complex technical, systems and/or program issues affecting Medicaid and its services to members. Strong verbal and written communication skills. Knowledge of state and federal regulations as they apply to public assistance programs. Proficiency in Microsoft Word, Excel and PowerPoint. Demonstrated project management skills. Ability to travel to client and/or off-site locations weekly. The University of Massachusetts Chan Medical School welcomes all qualified applicants and complies with all state and federal anti-discrimination laws.
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