Principal Consultant – Medicare and Medicaid

Oracle

About The Position

The Principal Consultant for the State Consulting Organization is responsible for the following: Federal Reporting Understand Medicare data, data design, and relationships pertaining to the member, provider, and claim Create novel and standard insightful and "actionable" analytic designs for Medicare and Medicaid solutions Partner with data scientists on predictive and engagement models for financial evaluations and fraud vulnerabilities Communicate with internal and client leadership on findings and material design elements Create level-of-estimates (LOE) for assigned work Understanding federal reporting requirements for state CMS reporting, focusing on CMS-64, CMS-21, and CMS-37 Working with the architecture and development teams through active communication of requirements, risks, and delivery timeline Technical Writing Communicating to known and future clients the requirements and subsequent functionality operations Communicating in writing how to use federal reporting in a technical user guide, and presenting questions on state and federal requirements Strategy Developing strategic direction and proposals for public health initiatives, specifically around homelessness, foster care, and community engagement (social determinants) Learning and applying specific artificial intelligence (AI) methods to current reporting and case worker solutions Researching pubic health problems-to-be-solved and presenting market opportunities to management Only Oracle brings together the data, infrastructure, applications, and expertise to power everything from industry innovations to life-saving care. And with AI embedded across our products and services, we help customers turn that promise into a better future for all. Discover your potential at a company leading the way in AI and cloud solutions that impact billions of lives. True innovation starts when everyone is empowered to contribute. That’s why we’re committed to growing a workforce that promotes opportunities for all with competitive benefits that support our people with flexible medical, life insurance, and retirement options. We also encourage employees to give back to their communities through our volunteer programs. We’re committed to including people with disabilities at all stages of the employment process. If you require accessibility assistance or accommodation for a disability at any point, let us know by emailing [email protected] [[email protected]] or by calling 1-888-404-2494 in the United States. Oracle is an Equal Employment Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability and protected veterans’ status, or any other characteristic protected by law. Oracle will consider for employment qualified applicants with arrest and conviction records pursuant to applicable law.

Responsibilities

Understand Medicare data, data design, and relationships pertaining to the member, provider, and claim
Create novel and standard insightful and "actionable" analytic designs for Medicare and Medicaid solutions
Partner with data scientists on predictive and engagement models for financial evaluations and fraud vulnerabilities
Communicate with internal and client leadership on findings and material design elements
Create level-of-estimates (LOE) for assigned work
Understanding federal reporting requirements for state CMS reporting, focusing on CMS-64, CMS-21, and CMS-37
Working with the architecture and development teams through active communication of requirements, risks, and delivery timeline
Communicating to known and future clients the requirements and subsequent functionality operations
Communicating in writing how to use federal reporting in a technical user guide, and presenting questions on state and federal requirements
Developing strategic direction and proposals for public health initiatives, specifically around homelessness, foster care, and community engagement (social determinants)
Learning and applying specific artificial intelligence (AI) methods to current reporting and case worker solutions
Researching pubic health problems-to-be-solved and presenting market opportunities to management