Medicaid Eligibility Consultant II – HigherEdJobs

Job Number: 2026-50070
Department: ForHealth Consulting – Third Party
Liability – W401920
Job Type: Full-Time
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 of 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; and
• 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

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