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 homelessness, foster care, and community engagement (social determinants)

• Learning and applying specific artificial intelligence (AI) methods to current reporting and case worker solutions

• Researching pubic health problems-to-be-solved and presenting market opportunities to management

Responsibilities

Principal Consultant Role Qualifications

• At least 4 years of total combined completed higher education and related work experience including:

• At least 2 year of project/program management work experience

• At least 4 years of completed higher education and/or additional work experience directly related to the duties of the job

• Expert knowledge of Medicare and Medicaid claims data, which includes financial, provider, and encounter data

• Knowledge of CMS requirements for US States

• Knowledge of T-MSIS reporting

• Product management

Preferred Qualifications

• Product Management

• Bachelor's degree in Business, Health Care, Information Technology

• Master's in Business Administration

• Project Management Professional (PMP) - Project Management Institute (PMI)

Disclaimer:

Certain U.S. based or U.S. customer or client-facing roles may be required to comply with applicable requirements, such as immunization/occupational health mandates, and/or drug testing requirements.

Range and benefit information provided in this posting are specific to the stated locations only

US: Hiring Range in USD from: $71,200 to $166,100 per annum. May be eligible for bonus and equity.

Oracle maintains broad salary ranges for its roles in order to account for variations in knowledge, skills, experience, market conditions and locations, as well as reflect Oracle's differing products, industries and lines of business.

Candidates are typically placed into the range based on the preceding factors as well as internal peer equity.

Oracle US offers a comprehensive benefits package which includes the following:

1. Medical, dental, and vision insurance, including expert medical opinion

2. Short term disability and long term disability

3. Life insurance and AD&D

4. Supplemental life insurance (Employee/Spouse/Child)

5. Health care and dependent care Flexible Spending Accounts

6. Pre-tax commuter and parking benefits

7. 401(k) Savings and Investment Plan with company match

8. Paid time off: Flexible Vacation is provided to all eligible employees assigned to a salaried (non-overtime eligible) position. Accrued Vacation is provided to all other employees eligible for vacation benefits. For employees working at least 35 hours per week, the vacation accrual rate is 13 days annually for the first three years of employment and 18 days annually for subsequent years of employment. Vacation accrual is prorated for employees working between 20 and 34 hours per week. Employees working fewer than 20 hours per week are not eligible for vacation.

9. 11 paid holidays

10. Paid sick leave: 72 hours of paid sick leave upon date of hire. Refreshes each calendar year. Unused balance will carry over each year up to a maximum cap of 112 hours.

11. Paid parental leave

12. Adoption assistance

13. Employee Stock Purchase Plan

14. Financial planning and group legal

15. Voluntary benefits including auto, homeowner and pet insurance

The role will generally accept applications for at least three calendar days from the posting date or as long as the job remains posted.

Career Level - IC3

About Us

Only Oracle brings together the data, infrastructure, applications, and expertise to power everything from industry innovations to life-saving care. And with AI embedded across our products and services, we help customers turn that promise into a better future for all. Discover your potential at a company leading the way in AI and cloud solutions that impact billions of lives.

True innovation starts when everyone is empowered to contribute. That’s why we’re committed to growing a workforce that promotes opportunities for all with competitive benefits that support our people with flexible medical, life insurance, and retirement options. We also encourage employees to give back to their communities through our volunteer programs.

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