Medicaid Eligibility & Program Integrity Consultant II

University of Massachusetts Medical School; Westborough (MA); On-site; USD 70,000 - 90,000; Full time

Job summary

University of Massachusetts Medical School seeks a Medicaid Eligibility Consultant II to support Medicaid eligibility and program integrity initiatives. You will analyze data, develop project plans, and collaborate with state agencies to align policies with IT systems.

The role requires 3–5 years in a related field, strong communication skills, and experience with Medicaid rules. Travel to client sites weekly is expected.

Qualifications

• Bachelor's degree or equivalent in a related field.
• 3–5 years of experience in a business-related field.
• Extensive knowledge of Medicaid policies and procedures.
• Familiarity with Medicaid systems and regulatory requirements.
• Proven communication and project management skills.

Responsibilities

• Perform complex analyses to support Medicaid eligibility and program integrity projects.
• Develop and track project plans, timelines, and documentation.
• Participate in multi-agency workgroups and client meetings.
• Assist with testing, system design, and defect resolution.
• Prepare presentations and marketing materials for clients.
• Support procurement processes (RFI/RFP) and cost analyses.
• Contribute to financial forecasting and savings initiatives.

Skills

Verbal communication

Written communication

Project management

Travel flexibility

Education

Bachelor's degree in business/health policy/public administration

Tools

Microsoft Word

Microsoft Excel

PowerPoint

Job description

University of Massachusetts Medical School seeks a Medicaid Eligibility Consultant II to support Medicaid eligibility and program integrity initiatives. You will analyze data, develop project plans, and collaborate with state agencies to align policies with IT systems.

The role requires 3–5 years in a related field, strong communication skills, and experience with Medicaid rules. Travel to client sites weekly is expected.