Medicaid Eligibility Consultant II
About The Position
Under the general direction of the Senior Associate or designee, the Medicaid Eligibility Consultant II assists in developing contracts with state agencies in and out of state. This detail-oriented professional applies Medicaid-related experience and analytical and organizational skills to support Medicaid eligibility and program integrity initiatives, as well as the design, development, and implementation of Medicaid eligibility systems. The role conducts complex analysis and research, contributes to project expansion plans, prepares presentations and marketing materials, and supports senior staff during client meetings and visits. It also contributes to agreements between public entities and the University and supports Medicaid systems development on behalf of client Medicaid agencies. This includes serving as a supporting subject matter expert on Medicaid eligibility regulations, operations, and processes; helping align systems work with agency needs and strategic objectives; participating in workgroups and stakeholder meetings; reviewing system design requirements; and assisting with testing and defect resolution. The consultant also supports procurement activities, project forecasting, cost analysis, financial planning and savings initiatives, staff presentations, and the development and completion of project and implementation plans. Weekly travel to client or off-site locations is required.
Requirements
- Bachelor's degree or equivalent in a business, health policy, social service, or public administration-related field.
- Three to five years of experience in a business-related field.
- Extensive and in-depth knowledge of Medicaid policies, programs, and procedures, and ability to integrate this knowledge with new and existing IT systems.
- Familiarity 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 applicable to public assistance programs.
- Demonstrated experience with Microsoft Word, Excel, and PowerPoint.
- Demonstrated project management skills.
- Ability to travel weekly to client and/or off-site locations.
Responsibilities
- Conduct complex analysis for Medicaid eligibility and program integrity projects in and out of state.
- Perform research and development analysis for Medicaid eligibility and/or program integrity revenue management and cost-savings projects.
- Contribute to program and project expansion plans.
- Contribute to presentations and prepare marketing materials for clients.
- Provide on-site support to senior staff during client visits and meetings.
- Participate in developing agreements between public entities and the University.
- Serve as a supporting subject matter expert on Medicaid eligibility regulations, operations, and processes for the design, development, and implementation of changes to Medicaid MAGI and non-MAGI eligibility systems.
- Help present Medicaid agency business needs and strategic vision in systems development activities and ensure alignment with agency objectives.
- Participate in multi-agency workgroups supporting development of a common eligibility application.
- Participate in meetings with upstream and downstream systems stakeholders to assess needs and provide solutions.
- Attend business and system design sessions.
- Review, provide feedback on, and approve appropriate business system design requirements.
- Attend regularly scheduled and ad hoc meetings virtually and onsite.
- Assist with testing and resolution of system defects.
- Support procurement processes, including Request for Information and Request for Proposal development.
- Contribute to project forecasting and complete assigned cost analysis tasks in support of financial planning and savings initiatives.
- Participate in presentations to staff about initiative successes and merits.
- Independently research, develop, and prepare work and implementation plans for projects and initiatives.
- Complete assigned projects from start to finish.
- Travel weekly to client and/or off-site locations.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
