Medicaid EQR Program Manager

Health Services Advisory Group, Inc.; Phoenix (AZ); On-site; USD 77,000 - 95,000; Full time

Job summary

Health Services Advisory Group (HSAG) is seeking a Project Manager to lead Medicaid compliance and readiness reviews, and to contribute to annual EQR reports. You will manage work plans, coordinate with state agencies, health plans, and internal teams, and prepare compliance and technical reports.

Ideal candidates have a health-related bachelor's degree with 5+ years in Medicaid managed care compliance or related auditing, plus strong communication and project-management skills.

Qualifications

• Bachelor's degree in a health-related field or equivalent plus experience in Medicaid compliance.
• Master’s degree preferred for advanced qualifications.
• Minimum five years of Medicaid managed care compliance experience.

Responsibilities

• Provide day-to-day project management and support of contracted EQR activities.
• Develop, coordinate, and manage project work plans and timelines.
• Prepare project documentation and support for contracts and projects.
• Identify opportunities to improve project processes and support quality improvement.
• Prepare audit and readiness review tools and materials.
• Prepare and deliver audit packets to health plans for desk reviews.
• Coordinate submission of documents from health plans for review.
• Conduct on-site or virtual compliance reviews of Medicaid managed care plans.
• Travel for onsite reviews; manage schedules across time zones.
• Develop, collect, analyze, and report data.
• Assist with audit reports and EQR technical reports.
• Research CMS/state rules and apply them to EQR work.

Skills

Communication skills

Interpersonal skills

Time management

Quality improvement

Utilization management

Care management

Windows suite (Outlook/Word/Excel)

Remote teamwork

Education

Bachelor's degree in health-related field

Master’s degree preferred

Job description

Health Services Advisory Group (HSAG) is seeking a Project Manager to lead Medicaid compliance and readiness reviews, and to contribute to annual EQR reports. You will manage work plans, coordinate with state agencies, health plans, and internal teams, and prepare compliance and technical reports.

Ideal candidates have a health-related bachelor's degree with 5+ years in Medicaid managed care compliance or related auditing, plus strong communication and project-management skills.