Senior Consultant - Medicare and Medicaid

Job Description The Senior Consultant for the State Consulting Organization plays a crucial role in facilitating our Medicare and Medicaid initiatives. Federal Reporting Develop a comprehensive understanding of Medicare data, including member, provider, and claim relationships. Design innovative and actionable analytic solutions for Medicare and Medicaid. Collaborate with data scientists to formulate predictive models for financial evaluations and identify potential fraud vulnerabilities. Effectively communicate findings and material design elements to both internal teams and client leadership. Generate level-of-estimates (LOE) for assigned projects. Understand federal reporting requirements for state CMS reporting, especially CMS-64, CMS-21, and CMS-37. Engage with architecture and development teams to communicate requirements, assess risks, and manage delivery timelines. Technical Writing Create clear communications to current and prospective clients outlining operational requirements and functionalities. Draft user guides detailing federal reporting processes, addressing both state and federal requirements. Strategy Formulate strategic proposals for public health initiatives targeting issues such as homelessness, foster care, and community engagement related to social determinants. Acquire knowledge in specific artificial intelligence (AI) methods applicable to reporting and case worker solutions. Conduct research on public health challenges and present market opportunities to management. Qualifications Minimum of 4 years of combined educational and relevant work experience, including: At least 2 years in project/program management. A deep understanding of Medicare and Medicaid claims data encompassing financial, provider, and encounter data. Familiarity with CMS requirements for US States. Knowledge of T-MSIS reporting. Experience in product management. Preferred Qualifications Experience in Product Management. Bachelor's degree in Business, Health Care, or Information Technology. Master's in Business Administration. Project Management Professional (PMP) certification from the Project Management Institute (PMI). Disclaimer Certain customer-facing roles may require compliance with immunization and occupational health mandates. Salary and Benefits US Hiring Range: $71,200 to $158,200 annually. Eligibility for bonus and equity may apply. Our compensation structure reflects various factors such as experience, market conditions, and internal equity. We offer a competitive benefits package, including but not limited to: Medical, dental, and vision insurance. Short and long-term disability insurance. Life insurance and AD&D coverage. Flexible Spending Accounts for healthcare and dependents. 401(k) plan with company match. Generous paid time off including flexible vacation and sick leave. Paid parental leave and adoption assistance. Employee Stock Purchase Plan. Voluntary benefits including home and auto insurance. This role will accept applications for at least three days from the posting date or as long as the listing remains active. About Us Join Oracle, where we combine data, infrastructure, applications, and expert knowledge to drive innovation and enhance healthcare solutions. With AI integrated throughout our services, we empower clients to improve lives. We believe in fostering a diverse workforce and supporting our employees with exceptional benefits to promote work-life balance. Oracle is an Equal Employment Opportunity Employer committed to creating an inclusive environment for all candidates. #J-18808-Ljbffr Broughton Group