Overview
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 Medicaid Eligibility Consultant II should be an insightful, detail-oriented professional with Medicaid-related experience, excellent analytical and organizational skills, and the ability to support 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 both in and out of state. Perform research and development analysis relevant to Medicaid eligibility and/or program integrity revenue management and cost savings projects. Contribute to the development of program and project expansion plans. Assist in developing presentations and marketing materials for clients. Provide on-site support during client visits and meetings. Participate in developing agreements between public entities and the University. Support Medicaid systems development on behalf of client Medicaid agencies, including: - Serving as a Subject Matter Expert (SME) in Medicaid eligibility regulations, operations, and processes.
- Assisting in presenting business needs and strategic vision for systems development.
- Participating in multi-agency workgroups for a common eligibility application.
- Engaging with stakeholders to assess needs and provide solutions.
- Attending design sessions, reviewing requirements, and providing feedback.
- Supporting testing and resolving system defects.
Support procurement processes such as RFI and RFP development. Contribute to project forecasting and complete cost analysis tasks supporting financial planning and savings initiatives. Participate in staff presentations regarding project successes and merits. Research, develop, and implement work plans for projects and initiatives, completing projects independently from start to finish. Qualifications
- Bachelor's Degree or equivalent in business, health policy, social services, or public administration.
- 3 to 5 years of experience in a related business field.
- Extensive knowledge of Medicaid policies, programs, and procedures, with the ability to integrate this knowledge with IT systems.
- Familiarity with complex technical, systems, and program issues affecting Medicaid services.
- Strong verbal and written communication skills.
- Knowledge of state and federal regulations applicable to public assistance programs.
- Proficiency in Microsoft Word, Excel, and PowerPoint.
- Project management experience.
- Ability to travel weekly to client and off-site locations.
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