Medicaid Eligibility Consultant II

University of Massachusetts Medical School; Westborough (MA); On-site; USD 80,000 - 90,000; Full time

Benefits offered by this job

Comprehensive Total Rewards package

Paid time off

Medical, dental, and vision coverage

401(a) retirement plan

403(b) plan options

Job summary

A public educational institution is seeking a Medicaid Eligibility Consultant II to support contracts with state agencies. Responsibilities include conducting complex analyses, contributing to project plans, and ensuring compliance with Medicaid policies. The ideal candidate should have a Bachelor's degree, with 3-5 years of relevant experience and strong communication skills. This position offers a hybrid work model and a competitive salary range between $80,000 and $90,000.

Qualifications

• 3 to 5 years of experience in a business related field.
• Extensive knowledge of Medicaid policies and procedures.
• Ability to travel to clients off-site weekly.

Responsibilities

• Conduct complex analysis to support Medicaid projects.
• Perform research and development analysis for cost savings.
• Provide on-site support during client meetings.

Skills

Verbal communication

Written communication

Project management

Analytical skills

Medicaid knowledge

Education

Bachelor's Level Degree in relevant field

Tools

Microsoft Word

Microsoft Excel

Microsoft PowerPoint

Job description

Medicaid Eligibility Consultant II

Job Number: 2025-48916

Category: Administrative Professional

Location: Westborough, MA

Shift: Day

Exempt/Non-Exempt: Exempt

Business Unit: ForHealth Consulting

Department: ForHealth Consulting - Third Party Liability - W401920

Job Type: Full-Time

Union Code: Non Union Position -W60- Non Unit Professional

Num. Openings: 1

Post Date: Oct. 31, 2025

Work Location: Hybrid

Salary Minimum: USD $80,000.00/Yr.

Salary Maximum: USD $90,000.00/Yr.

Under the general direction of the Senior Associate or designee, the Medicaid Eligibility Consultant II will assist in the development of contracts with state agencies; both in and out of state. The Medicaid Eligibility Consultant II should be an insightful, detail-oriented professional with Medicaid-related experience, excellent analytical and organizing skills who is able to apply that skill set to support both Medicaid Eligibility and Program Integrity Initiatives as well as the design, development and implementation of Medicaid eligibility systems.

Responsibilities:

• Conduct complex analysis to support Medicaid eligibility and program integrity projects in and out of state.
• Perform research & development analysis relevant to Medicaid eligibility and/or program integrity revenue management/cost savings projects as assigned.
• Contribute to the development of program and project expansion plans.
• Contribute to the development of presentations and the preparation of marketing materials to clients.
• Provide on-site support to senior staff during client visits and meetings.
• Participate in the development of agreements between public entities and the University.
• Participate in the development of Medicaid systems on behalf of the client Medicaid agency:
• Serve as a Supporting Subject Matter Expert (SME) in Medicaid eligibility regulations, operations, and processes to support the design, development, and implementation of changes to Medicaid MAGI and non-MAGI eligibility systems.
• Assist with presenting Medicaid agency business needs and strategic vision in systems development activities and ensure they align with agency objectives.
• Participate in multi-agency workgroups supporting the development of a common eligibility application.
• Participate in meetings with the systems upstream and downstream stakeholders to assess needs and provide solutions.
• Attend business and system design sessions.
• Review, provide feedback and approve appropriate business system design requirements.
• Attend regularly scheduled and ad hoc meetings virtually and onsite.
• Assist with testing and resolution of system defects.
• Support procurement processes such as Request for Information (RFI) and Request for Proposal (RFP) development.
• Contribute to project forecasting and complete assigned cost analysis tasks in support of financial planning and savings initiatives.
• Participate in presentations to staff regarding success, merits of initiative, etc.
• Independently research, develop, and prepare work and implementation plans in support of project and initiatives. Complete assigned projects from start to finish.

Qualifications:

• Bachelor's Level Degree or equivalent in a business, health policy, social service, or public administration related field.
• 3 to 5 years of experience in a business related field.
• Extensive and in-depth knowledge of Medicaid policies, programs and procedures and the ability to integrate this knowledge with new and existing IT systems.
• Familiarity working with complex technical, systems and/or programs issues affecting Medicaid and its services to members.
• Strong verbal and written communication skills.
• Must have knowledge of state and federal regulations as they apply to public assistance programs.
• Demonstrated experience in Microsoft Word, Excel and PowerPoint.
• Demonstrated project management skills.
• Ability to travel to the client and/or off- site locations weekly.

Posting Disclaimer: This job posting outlines the primary responsibilities and qualifications for the role but is not intended to be an exhaustive list. Duties and expectations may evolve in response to the needs of the department and the broader institution.

In alignment with our commitment to pay transparency, the base salary range for this position is listed above (exclusive of benefits and retirement). At UMass Chan Medical School, final base salary offers are determined based on a combination of factors, including your skills, education, and relevant experience. We also consider internal equity to ensure fair and consistent compensation across our teams.

Please note that the range provided reflects the full base salary range for this position. Offers are typically made within the midrange to allow for future growth and development within the role.

In addition to base pay, UMass Chan offers a comprehensive Total Rewards package, which includes paid time off, medical, dental, and vision coverage, and participation in a 401(a)-retirement plan, with the option to contribute to a voluntary 403(b) plan.

UMass Chan welcomes all qualified applicants and complies with all state and federal anti-discrimination laws.