SEARCH CAREER OPPORTUNITIES

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.

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

ADDITIONAL RESPONSIBILITIES:

• Lead Program Development projects as assigned
• Act as project manager for in-state and out-of-state projects as assigned.
• Oversee client relationships 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.