Medicaid Eligibility Consultant III

Medicaid Eligibility Consultant III – For Health Consulting at UMass Chan Medical School

Join to apply for the Medicaid Eligibility Consultant III role at For Health Consulting at UMass Chan Medical School.

• Provide strategic oversight and lead development, management, coordination and implementation of Medicaid eligibility and program integrity initiatives, in and out of state.
• Serve as project lead in the analysis and evaluation of data to support Medicaid eligibility and program integrity cost savings projects in and out of state.
• Lead in the research & development of new business opportunities.
• Direct and manage assigned projects from start to finish.
• Develop comprehensive work plans, define resource needs, and allocate tasks to support efficient project execution.
• Provide strategic leadership in the development of Medicaid systems on behalf of the client Medicaid agency, including serving as the Lead Subject Matter Expert (SME) in Medicaid eligibility regulations, operations, and processes to support design, development, and implementation of changes to Medicaid MAGI and non‑MAGI eligibility systems.
• Assist with testing and resolution of system defects.
• Lead the development of agreements between public entities and the University.
• Assist in the evaluation and response to grant and business proposals by providing reporting and data analysis.
• Develop and present successes and merits of initiatives to staff and clients.
• Research and develop work plans to implement projects.
• Coordinate with subcontractors to obtain data for various initiatives.

• Master’s Level Degree or equivalent in a business health policy, social service, or public administration related field.
• 5‑7 years experience in a related field.
• Extensive experience interpreting State and Federal regulations as they apply to public assistance programs.
• Extensive and in‑depth knowledge of Medicaid policies, programs and procedures and the ability to integrate this knowledge with new and existing IT systems.
• Experience working with complex technical, systems and/or program issues affecting Medicaid and its services to members.
• Excellent verbal and written communication skills.
• Project management skills and experience in implementing and managing large projects.
• Demonstrated ability to work numerous projects simultaneously and meet deadlines.
• Experience in supervision and/or the ability to manage and motivate staff.
• Expertise in Microsoft Word, Excel, PowerPoint and Access or SQL.
• Ability to travel to the client and/or off‑site locations weekly.

• Strong quantitative and analytical skills.
• Ability to facilitate meetings and establish working relationships with various government and private contractors.
• Exceptional oral and written communication skills.
• Exceptional organizational skills.
• Team leadership skills.

The University of Massachusetts Chan Medical School welcomes all qualified applicants and complies with all state and federal anti‑discrimination laws.