Medicaid Policy & Regulation Analyst Position

Peraton; United States; Remote; USD 66,000 - 106,000; Full time

Job summary

Peraton is seeking a policy analyst to support Medicaid initiatives under the SGS NE UPIC contract. You will research and articulate Federal and State regulations, serving as a subject matter expert to educate the team and respond to referrals.

The role requires translating complex policies into actionable guidance, engaging with state counterparts and CMS, and tracking policy developments to inform project decisions. Telework is available from all states.

Qualifications

• 5 years with BS/BA or 9 years with a HS Diploma.
• At least 5 years' experience in policy research and analysis.
• Ability to present and discuss state policies and regulations in connection with project impact.
• Ability to research policies, interpret regulations and regulatory rules/guidance.
• Excellent oral and written communications; able to communicate at all levels.

Responsibilities

• Research, understand, and articulate Federal and State regulations and policy as they relate to State Medicaid programs in the northeastern jurisdiction.
• Act as subject matter expert, educate in tandem with project development or in response to referrals.
• Articulate policy/regulations in written form and through discussions/presentations.
• Provide written policy contributions for incorporation into Analytical Findings Reports.
• Identify program vulnerabilities arising from policy research.
• Interact with states and CMS to discuss policy.
• Keep abreast of emerging issues affecting state Medicaid programs.

Skills

Policy research

Policy analysis

Presentation skills

Regulatory interpretation

MS Office

US citizenship

Education

Bachelor's degree (BS/BA)

High School Diploma

Tools

Microsoft Office

Job description

About Peraton

Peraton is a next-generation national security company that drives missions of consequence spanning the globe and extending to the farthest reaches of the galaxy. As the world's leading mission capability integrator and transformative enterprise IT provider, we deliver trusted, highly differentiated solutions and technologies to protect our nation and allies. Peraton operates at the critical nexus between traditional and nontraditional threats across all domains: land, sea, space, air, and cyberspace. The company serves as a valued partner to essential government agencies and supports every branch of the U.S. armed forces. Each day, our employees solve the most daunting challenges that our customers face. Visit peraton.com to learn how we're keeping people around the world safe and secure.

About Peraton

Peraton is a next-generation national security company that drives missions of consequence spanning the globe and extending to the farthest reaches of the galaxy. As the world's leading mission capability integrator and transformative enterprise IT provider, we deliver trusted, highly differentiated solutions and technologies to protect our nation and allies. Peraton operates at the critical nexus between traditional and nontraditional threats across all domains: land, sea, space, air, and cyberspace. The company serves as a valued partner to essential government agencies and supports every branch of the U.S. armed forces. Each day, our employees solve the most daunting challenges that our customers face. Visit peraton.com to learn how we're keeping people around the world safe and secure.

Program Overview

Performs data analysis, investigation, and medical review to detect, prevent, deter, reduce, and make referrals to recover fraud, waste, and abuse in Medicare and Medicaid programs.

About The Role

SafeGuard Services (SGS), a subsidiary of Peraton, performs data analysis, investigation, and medical review to detect, prevent, deter, reduce, and make referrals to recover fraud, waste, and abuse.

What you'll do

This position is on the SGS NE UPIC contract supporting Medicaid initiatives across the northeastern jurisdiction. The northeastern jurisdiction includes the following states: Maine, Vermont, New Hampshire, Massachusetts, Rhode Island, Connecticut, New York, New Jersey, Pennsylvania, Delaware, Maryland, and the District of Columbia.

This individual's primary responsibilities are to research, understand, and articulate Federal and State regulations and policy as they relate to the administration of the State Medicaid programs for those states within the northeastern jurisdiction. As the subject matter expert, the position will work to gain an understanding of these programs and their respective nuances by state and work with the greater Medicaid team to primarily research and educate in tandem with project development or in response to referrals.

Additional Responsibilities

• Articulate policy/regulations in both a written manner and through discussion/presentation.
• Provide a written policy contribution for incorporation into the Analytical Findings Report.
• Consult to identify projects in collaboration with the Project Coordination team and the Data team.
• Identify potential program vulnerabilities arising out of policy research.
• Interact with the states in the jurisdiction to engage in policy discussion.
• Interact with CMS to engage in policy discussion.
• Keep abreast of emerging issues and developments that have direct impact on the state Medicaid programs within the jurisdiction.
• Assist the Medicaid Operations Lead with special research projects as requested.
• Ownership of the Medicaid Policies & Procedures Manual to include an annual review to determine if direction is current, which may include needed updates as well as ad hoc updates as direction changes (i.e., internally or by the customer).
• Track policy workload and report monthly to the Medicaid Operations Lead.
• Oversee state meeting agendas and minutes process in coordination with the Business Analyst.
• Position will be Telework available from all states and time zone(s).

Qualifications

Basic Qualifications

• 5 years with BS/BA or 9 years with a HS Diploma
• At least 5 years' experience in policy research and analysis.
• Ability to present and discuss state policies and regulations in connection with project impact.
• Ability to research policies, interpret regulations and regulatory rules/guidance.
• Strong interpersonal skills: ability to work and make decisions independently and in a team environment.
• Excellent planning, organizational skills.
• Excellent oral and written communications; able to communicate and make presentation to all levels of management and associates at all levels throughout the Company.
• Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence.
• Ability to adapt to changing priorities, self-motivated and energetic qualities desirable.
• Experience using Microsoft Office (Word, Excel, Access, PowerPoint, and Outlook).
• US citizenship required

The most competitive candidates will have

• Experience with CMS programs - Medicaid and Medicare.
• Experience with Managed Care programs.
• Knowledge of CMS regulations related to State Medicaid programs to include waivers.
• Knowledge of CMS 64 - analyse and interpret reports to determine trends and vulnerabilities.
• Knowledge of Federal Matched Assistance Program to State Medicaid programs.
• Medical Coding knowledge/experience related to billing of Medicare/Medicaid claims a plus.

Details

Target Salary Range: $66,000 - $106,000. This represents the typical salary range for this position. Salary is determined by various factors, including but not limited to, the scope and responsibilities of the position, the individual's experience, education, knowledge, skills, and competencies, as well as geographic location and business and contract considerations. Depending on the position, employees may be eligible for overtime, shift differential, and a discretionary bonus in addition to base pay.

Benefits Statement: Peraton offers eligible employees a variety of benefits including medical, dental, vision, life, health savings account, short/long term disability, EAP, parental leave, 401(k), paid time off (PTO) for vacation, and company paid holidays. A full listing of available benefits can be viewed at https://www.careers.peraton.com/benefits.

EEO:Equal opportunity employer, including disability and protected veterans, or other characteristics protected by law.