Medicaid Eligibility & Systems Consultant II

UMass Med School; Westborough (MA); Vor Ort; USD 80.000 - 90.000; Vollzeit

Zusammenfassung

UMass Medical School in Westborough, MA is seeking a Medicaid Eligibility Consultant II to help shape eligibility and program integrity initiatives. This role focuses on ensuring member eligibility accuracy across Medicaid systems, supporting contract development with state agencies, and driving improvements in eligibility workflows.

The position requires Medicaid knowledge, strong analytical capabilities, and the ability to collaborate with multiple stakeholders on system design, testing, and

Qualifikationen

• Bachelor's degree or equivalent in a business, health policy, public administration, or related field.
• 3–5 years of experience in a business-related field.
• Extensive Medicaid policies, programs and procedures knowledge and ability to integrate with IT systems.
• Familiarity with complex technical, systems, or programs issues affecting Medicaid services.

Aufgaben

• Conduct complex analysis to support Medicaid eligibility and program integrity projects in and out of state.
• Perform research and development analysis related to Medicaid eligibility and cost-saving projects.
• Contribute to development of program and project expansion plans and client materials.
• Provide on-site support during client visits and meetings.
• Participate in development of Medicaid systems for the client agency and act as SME for MAGI and non-MAGI eligibility systems.
• Assist with presenting business needs and aligning system design with agency objectives.
• Participate in multi-agency workgroups to develop a common eligibility application.
• Attend design sessions and review/approve business system design requirements.
• Assist with testing and resolution of system defects and procurement processes (RFI/RFP).
• Contribute to project forecasts and cost analyses for financial planning.

Kenntnisse

Communication skills

Ausbildung

Bachelor's degree (business/health policy)

Tools

Microsoft Word

Microsoft Excel

PowerPoint

Jobbeschreibung

UMass Medical School in Westborough, MA is seeking a Medicaid Eligibility Consultant II to help shape eligibility and program integrity initiatives. This role focuses on ensuring member eligibility accuracy across Medicaid systems, supporting contract development with state agencies, and driving improvements in eligibility workflows.

The position requires Medicaid knowledge, strong analytical capabilities, and the ability to collaborate with multiple stakeholders on system design, testing, and