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.
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