Associate II – Medicaid Eligibility Consultant job - University of Massachusetts Medical School - Charlestown, MA

Commonwealth Medicine (CWM) is the consulting division of UMass Medical School. The CWM Center for Health Care Financing (CHCF) helps state and local governments, primarily in Massachusetts, identify opportunities to increase savings and reimbursements through federal and other third party sources, establish effective savings and reimbursement programs and capitalize on all possible revenue streams. We identify opportunities for our clients to increase services and reduce the net cost of delivery.

GENERAL SUMMARY OF POSITION:
The Associate II – Medicaid Eligibility Consultant position reports to the Associate III or designee and will assist in the development, implementation, management, and coordination of Program Development projects both in- and out-of-state. This also includes business lead for work associated with the Massachusetts Health Insurance Exchange (HIX), including business rule development and member eligibility notices. The Associate II will lead project activities and teams, manage client interactions, and participate in initiatives from concept through execution and completion.


Responsibilities:
MAJOR RESPONSIBILITIES:
Perform complex analysis in support of projects in and out of state

Perform research & development analysis relevant to revenue management/enhancement projects as assigned

Assist in the development of program expansion plans

Assist in the development of presentations and the preparation of marketing materials to clients

Support senior staff on site visits

Participate in the development of agreements between public entities and the University

Participate in Request for Information/Request for Proposal processes

Participate in project forecasting and work on assigned financial analysis projects.

Participate in presentations to staff regarding success, merits of initiative, etc.

Research, develop, and prepare work and implementation plans in support of project and initiatives. Complete assigned projects from start to finish

Assist in coordinating with subcontractors to obtain databases for various revenue initiatives

Participate in training staff and clients (in and out of state) in types of reimbursable initiatives

Provide technical support in the preparation of federal claims for reimbursement

Coordinate communications with clients about status of their projects

Prepare internal and external reports

Participate in the Continuous Quality Improvement program

Perform other duties as required.


Qualifications:
REQUIRED QUALIFICATIONS:
Masters degree and 3 -5 years of experience in a business related field, or equivalent experience

Must have knowledge of State and Federal regulations as they apply to public assistance programs

Demonstrated experience in computer based tools including spreadsheets and word processing

Knowledge of accounting principles, budgeting, and computer reporting preparation

Demonstrated project management skills.

Ability to travel to off-site locations


Additional Information:
ADDITIONAL RESPONSIBILITIES:
Lead Program Development projects as assigned

Act as project manager for in-state and out-of-state projects as assigned.

Oversee client relationship in a positive manner

Provide policy and operations support to MassHealth as it transitions from legacy eligibility system to MA HIX/IES

Draft high quality presentations and written materials.

Prepare agendas, lead and facilitate meetings

Draft MassHealth eligibility training materials for eligibility and customer service staff

Assist with implementation of new Medicaid/CHIP eligibility policies for in state and out of state clients

Collaborate and coordinate activities with other Commonwealth Medicine units as necessary.

Lead in the preparation and presentation of staff and client presentations and trainings, as needed

PREFERRED QUALIFICATIONS

Direct experience and knowledge of Medicaid eligibility policy, systems and operations

Experience in program development and process improvement

Experience working with state agencies, preferably health and human services agencies

Experience performing, documenting, and organizing research on health and human service policies, regulations, programs, and organizations

Ability to lead a team with diverse backgrounds, areas of expertise, and levels of experience

Ability to identify and analyze project requirements to create and adjust project work plans and timelines to meet defined deadlines and goals

This position is in the Schrafft’s Building, located in Charlestown, Massachusetts, just north of Boston and easily accessible by public transportation.



Source link



Related Posts


EmoticonEmoticon

:)
:(
=(
^_^
:D
=D
=)D
|o|
@@,
;)
:-bd
:-d
:p
:ng
:lv