Senior Government Consultant – Systems & Encounter Specialist

• Learn and analyze how systems and processes function across different information technology domains
• Lead and support structured assessments and audits of systems and data, including ISCA and EDV
• Document assessment findings, observations, and recommendations
• Lead and contribute to client deliverables, presentations, and project documentation
• Collaborate with cross-functional teams to translate regulatory requirements into system and data processes
• Analyze, validate, and troubleshoot encounter data across multiple systems
• Deliver accurate, timely, and insightful analysis to project teams
• Engage Medicaid leadership, providers, and beneficiaries to gather feedback and inform program recommendations
• Manage the quality and timeliness of client deliverables
• Communicate regularly and effectively with project teams

• Bachelor’s degree in Information Systems, Computer Science, Healthcare Administration, Data Analytics, or related field
• 3+ years of experience with healthcare systems, data and system analysis, or consulting
• Knowledge of Medicaid policies, regulations, and program operations
• Understanding and experience with healthcare data systems, including encounter data, claims systems, or EHR platforms
• Familiarity with data quality assessment, validation techniques, and reconciliation processes
• Understanding of Medicaid, Medicare, or other government healthcare programs
• Knowledge of encounter data submission processes and regulatory requirements
• Familiarity with managed care organizations or state healthcare systems
• Strong problem-solving and critical thinking abilities
• Ability to translate technical findings into clear, client-friendly insights
• Experience in a consulting, client-facing, or project-based environment
• Strong organizational skills and ability to manage multiple priorities
• Hands-on experience with encounter data in Medicaid or managed care environments
• Exposure to system implementation or migration projects
• Ability to bridge technical teams and business stakeholders
  
  Strong communication skills for presenting findings to non-technical audiences
• Experience working with CMS, state Medicaid agencies, or healthcare consulting
• Strategic mindset for developing innovative solutions to complex challenges
• Strong stakeholder management skills with Medicaid leadership, providers, and beneficiaries

Demonstrates expertise in healthcare systems analysis, including encounter data and claims systems, while effectively communicating technical findings to diverse stakeholders. Proven ability to lead assessments, manage client deliverables, and navigate Medicaid policies and regulations.

• Healthcare Systems Analysis
• Medicaid Policies Knowledge
• Encounter Data Management
• Client-Facing Experience
• Data Quality Assessment

• Data Analysis
• System Audits
• Regulatory Requirements Translation
• Data Validation Techniques
• EHR Platforms
• Claims Systems
• Encounter Data Submission
• System Implementation
• Reconciliation Processes
• Project Documentation

• Problem-Solving
• Critical Thinking
• Organizational Skills
• Communication Skills
• Stakeholder Management

• Medicaid
• Medicare
• Managed Care Organizations
• Healthcare Administration
• Data Analytics
• Government Healthcare Programs
• Client Deliverables
• Cross-Functional Collaboration
• Project-Based Environment
• Feedback Engagement