Medicaid Policy and Regulation Analyst

Job Description:

• Research, understand, and articulate Federal and State regulations and policy related to administration of State Medicaid programs in the northeastern jurisdiction
• Serve as a subject matter expert on State Medicaid programs and their state-specific nuances
• Research and educate in collaboration with the greater Medicaid team, project development, and referrals
• Articulate policy and regulations in writing and through discussion or presentation
• Provide written policy contributions for incorporation into Analytical Findings Reports
• Consult with Project Coordination and Data teams to identify projects
• Identify potential program vulnerabilities arising from policy research
• Engage with states in the jurisdiction in policy discussions
• Engage with CMS in policy discussions
• Monitor emerging issues and developments affecting State Medicaid programs
• Assist the Medicaid Operations Lead with special research projects
• Own and annually review the Medicaid Policies & Procedures Manual, making updates as needed
• Track policy workload and report monthly to the Medicaid Operations Lead
• Oversee state meeting agendas and minutes in coordination with the Business Analyst

Requirements:

• 5 years with BS/BA or 9 years with a high school 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 and ability to work and make decisions independently and in a team environment
• Excellent planning and organizational skills
• Excellent oral and written communications; able to communicate and make presentations to all levels of management and associates throughout the company
• Ability to meet established deadlines and handle multiple customer service demands within set expectations for service excellence
• Ability to adapt to changing priorities; self-motivated and energetic qualities desirable
• Experience using Microsoft Office, including Word, Excel, Access, PowerPoint, and Outlook
• US citizenship required
• Experience with CMS programs, including Medicaid and Medicare, preferred for competitive candidates
• Experience with Managed Care programs preferred for competitive candidates
• Knowledge of CMS regulations related to State Medicaid programs, including waivers, preferred for competitive candidates
• Knowledge of CMS 64 and ability to analyze and interpret reports to determine trends and vulnerabilities preferred for competitive candidates
• Knowledge of Federal Matched Assistance Program to State Medicaid programs preferred for competitive candidates
• Medical coding knowledge/experience related to Medicare/Medicaid claims is a plus

Benefits:

• Telework available from all states and time zone(s)
• Potential eligibility for overtime
• Potential eligibility for shift differential
• Potential eligibility for a discretionary bonus
• Equal opportunity employment, including disability and protected veterans protections