Medicaid DSH Payment Analysis Specialist

TeleSolv Group; Pierre (SD); On-site; USD 95,000 - 105,000; Full time

Job summary

TeleSolv Consulting is seeking a Medicaid DSH Payment Analysis Specialist to provide expert analysis and technical support for a Government Medicaid DSH program. The role focuses on calculating rates, validating hospital data, and ensuring compliance with evolving regulations.

You will assess policy changes, support audits, and prepare final payment-model calculations for the upcoming state fiscal year, while coordinating with hospitals and Government stakeholders.

Qualifications

• Experience with Medicaid data and DSH rules.
• Ability to interpret federal policy changes and relevant court decisions.
• Proven data reconciliation and validation skills.
• Ability to work independently and meet deadlines.

Responsibilities

• Assess recent court decisions and federal policy changes for potential effects on Medicaid program.
• Assess State Plan resubmissions when necessary.
• Evaluate current administration of DSH payments and suggest improvements.
• Support DSH program audits.
• Identify and collect information from providers.
• Gather data from hospitals, Government and other sources.
• Review submitted data for reasonableness and accuracy.
• Resolve data discrepancies with stakeholders.
• Calculate DSH rates and supplemental payments.
• Develop a draft DSH payment schedule for the upcoming state fiscal year.
• Calculate the DSH payment model for the year under review.
• Discuss draft results with Government stakeholders and modify as needed.
• Deliver final payment-model calculations as required.
• Draft communications to hospitals about methodology and deadlines.
• Obtain Government approval before outreach.
• Develop education on DSH requirements and data sources.
• Maintain project quality and complete work on schedule.

Skills

Medicaid data analysis

DSH rules knowledge

Data collection & validation

Payment rates modeling

Regulatory interpretation

Stakeholder communication

Remote work ability

Travel for on-site work

Job description

Medicaid DSH Payment Analysis Specialist

Application Deadline: 1 June 2027

Department: Federal Services

Employment Type: Full Time

Location: Pierre, SD

Compensation: $95,000 - $105,000 / year

Description

TeleSolv Consulting is seeking an experienced DSH Analysis and Supplemental Payment Consultant to provide technical support and analytical expertise for a Government Medicaid Disproportionate Share Hospital, or DSH, supplemental payment program.

The consultant will assess regulatory and policy developments, evaluate program administration, collect and validate hospital data, calculate DSH rates and payments, and support program audits. The successful candidate must be able to perform detailed analytical work independently, communicate effectively with participating hospitals and Government stakeholders, and deliver accurate work within established deadlines.

Key Responsibilities

• Assess recent court decisions and federal policy changes or clarifications for their potential effect on the Government’s Medicaid program.
• Assess the appropriateness of State Plan resubmissions when necessary.
• Evaluate the current administration of DSH supplemental payments and recommend potential improvements.
• Support DSH program audits.
• Identify and collect the information and documentation required from qualified and eligible providers.
• Gather applicable data from eligible hospitals, the Government and other relevant sources.
• Review submitted data for reasonableness and accuracy.
• Work with hospitals and Government stakeholders to resolve data discrepancies.
• Calculate DSH rates and supplemental payments.
• Develop a draft DSH payment schedule for the upcoming state fiscal year.
• Calculate the DSH payment model for the year under review.
• Review and discuss draft payment-model results with Government stakeholders.
• Modify payment-model calculations when requested by the Government.
• Deliver final payment-model calculations in the format specified by the Government.
• Draft proposed communications to eligible hospitals concerning methodology, data collection and submission deadlines.
• Obtain Government approval before conducting outreach to participating hospitals.
• Develop and deliver education on DSH requirements, data sources, survey tools and documentation practices.
• Maintain project quality through proven standards and methodologies.
• Complete assigned work on schedule.

Skills, Knowledge & Expertise

• Knowledge of Medicaid data and healthcare payment information.
• Detailed understanding of DSH rules, regulations and related issues.
• Detailed understanding of Medicaid rules, regulations and related issues.
• Ability to interpret federal policy changes and relevant court decisions.
• Ability to collect, reconcile and validate data from multiple sources.
• Ability to identify and resolve discrepancies in hospital and Government data.
• Experience calculating payment rates, payment models and schedules.
• Ability to prepare clear communications for participating hospitals.
• Ability to explain technical DSH requirements, data sources and survey tools to stakeholders.
• Strong quality-control, documentation and time-management capabilities.
• Ability to work independently in a remote environment and travel on-site when required.

Qualifications

• Experience working with Medicaid data.
• At least three years of experience working with DSH rules, regulations and related issues.
• At least three years of experience working with Medicaid rules, regulations and related issues.
• Ability to perform remote work within the continental United States.
• Ability to work on-site in Pierre, South Dakota, for a limited portion of the engagement when required.