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Project Lead - Medicaid Eligibility and Program Integrity (primarily remote)
Job Number: 2024-45263
Category: Administrative Professional
Location: Shrewsbury, MA
Shift: Day
Exempt/Non-Exempt: Exempt
Business Unit: ForHealth Consulting
Department: ForHealth Consulting - Third Party Liability - W401920
Job Type: Full-Time
Salary Grade: 46
Num. Openings: 1
Post Date: March 2, 2024

GENERAL SUMMARY OF POSITION:

Under the general direction of the Senior Associate or designee, the Associate II will assist in the development of contracts with state agencies; both in and out of state.

 

The ForHealth Consulting, Health Care Financing Solutions Eligibility and Benefit Coordination Team provides  project management services and expertise in Medicaid eligibility policy, systems and programs.  The Team continues a long-term engagement as subject matter experts in the development and implementation of eligibility systems and policy. This position will focus primarily on work supporting eligibility-related program integrity initiatives for Medicaid and health and human services programs.

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.

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

Remote Home Office with weekly on-site in Quincy, MA.

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