Government Operations Consultant III

Jobtailor; Tallahassee (FL); On-site; USD 75,000 - 110,000; Full time

Job summary

Jobtailor seeks a dedicated professional to manage Medicaid/Medicare contracts and lead cross-functional coordination for plan management operations.

You will ensure service delivery meets contractual requirements, analyze data to improve performance, and coordinate with administrative and clinical teams, including oversight of D-SNP programs.

Qualifications

• One year of Medicaid or Medicare Contract Management experience
• One year of contract or program related activities
• Knowledge of basic management principles and practices
• Knowledge of data collection and analysis methods
• Knowledge of health care facilities, operations, and management
• Knowledge of state procurement laws and contract management policies
• Word processing, spreadsheet and/or database software skills
• Ability to coordinate a consultative program to resolve managerial problems
• Ability to set work priorities and ensure completion
• Ability to communicate effectively
• Ability to establish and maintain relationships and work in a team
• Ability to assess budgets
• Ability to formulate policies and procedures
• Ability to understand and apply rules and procedures
• Ability to organize data for reports
• Ability to collect, evaluate, and analyze data to develop recommendations
• Ability to conduct fact-finding research
• Ability to work independently
• Ability to solve problems and make decisions
• Ability to travel with or without accommodations
• Criminal history background screening completed
• One year of data analysis experience preferred

Responsibilities

• Analyze, develop, implement, coordinate, and monitor contracted Medicare and Medicaid services
• Serve as contract manager and lead contact for assigned D-SNP contracts
• Plan and direct a consultative program to coordinate administration, program, and service-delivery functions
• Ensure Medicaid managed care plans meet contractual requirements and provide timely services
• Provide liaison to resolve operational and management problems
• Oversee Medicaid managed care programs including SMMC and D-SNP within the Bureau of Medicaid Plan Management Operations

Skills

Medicaid Contract Mgmt

Medicare Contract Mgmt

Data Collection & Analysis

State Procurement Laws

Effective Communication

Team Collaboration

Policy Formulation

Budgeting

Independent Work

Travel Ability

Education

None

Tools

Word Processing

Spreadsheet Software

Database Software

Job description

• Analyze, develop, implement, coordinate, and/or monitor contracted Medicare and Medicaid services
• Serve as contract manager and lead point of contact for assigned D-SNP contracts
• Plan and direct a consultative program to ensure coordination and efficiency across administrative, program, and operational service-delivery functions
• Ensure Medicaid managed care plans meet contractual requirements, including timely provision of medically needed services and provider payment
• Provide liaison and consultant capabilities to resolve operational and management problems
• Work within the Bureau of Medicaid Plan Management Operations, overseeing Medicaid managed care programs including SMMC and D-SNP

Requirements

• One year of Medicaid or Medicare Contract Management experience
• One year of experience working with contract or program related activities (e.g. compliance reviews, providing technical assistance)
• Knowledge of basic management principles and practices
• Knowledge of the methods of data collection and analysis
• Knowledge of health care facilities, operations, and management
• Knowledge of state procurement laws and contract management policies/procedures
• Knowledge of word processing, spreadsheet and/or database software as required
• Ability to coordinate a consultative program designed to ensure the resolution of managerial and operational problems
• Ability to determine work priorities and ensure proper completion of work assignments
• Ability to communicate effectively
• Ability to establish and maintain effective working relationships and work cooperatively as a team member
• Ability to assess budgetary needs
• Ability to formulate policies and procedures
• Ability to understand and apply applicable rules, regulations, policies and procedures
• Ability to organize data into logical formats for reports and written materials
• Ability to collect, evaluate and analyze data to develop recommendations, solve problems, and document work
• Ability to conduct fact-finding research
• Ability to work independently
• Ability to solve problems and make decisions
• Ability to travel with or without accommodations
• Successful completion of State and National criminal history background screening
• One year of experience analyzing data is preferred

Core Competencies

Demonstrates expertise in Medicaid and Medicare Contract Management, ensuring compliance with contractual requirements and effective service delivery. Proficient in data analysis, problem-solving, and establishing collaborative relationships to enhance operational efficiency.

Highest-signal resume keywords

• Medicaid Contract Management Experience
• Medicare Contract Management Experience
• Data Collection And Analysis
• Knowledge Of State Procurement Laws
• Ability To Communicate Effectively

Hard Skills

• Contract Management
• Data Analysis
• Compliance Reviews
• Policy Formulation
• Budget Assessment

Soft Skills

• Problem Solving
• Team Collaboration
• Effective Communication
• Independent Work

Certifications & Qualifications

• State And National Criminal History Background Screening

Industry Keywords

• Medicaid Managed Care
• Medicare Services
• Health Care Operations
• Service Delivery Functions
• D-SNP Contracts

Tools & Technologies

• Word Processing Software
• Spreadsheet Software
• Database Software