Principal Consultant – Medicare and Medicaid

Job description

The Principal Consultant for the State Consulting Organization is responsible for the following: Federal Reporting - Understand Medicare data, data design, and relationships pertaining to the member, provider, and claim - Create novel and standard insightful and "actionable" analytic designs for Medicare and Medicaid solutions - Partner with data scientists on predictive and engagement models for financial evaluations and fraud vulnerabilities - Communicate with internal and client leadership on findings and material design elements - Create level-of-estimates (LOE) for assigned work - Understanding federal reporting requirements for state CMS reporting, focusing on CMS-64, CMS-21, and CMS-37 - Working with the architecture and development teams through active communication of requirements, risks, and delivery timeline Technical Writing: - Communicating to known and future clients the requirements and subsequent functionality operations - Communicating in writing how to use federal reporting in a technical user guide, and presenting questions on state and federal requirements Strategy: - Developing strategic direction and proposals for public health initiatives, specifically around...