Medicaid Eligibility Consultant II
University of Massachusetts Medical SchoolShrewsbury, England, United Kingdom- Full-time
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Medicaid Eligibility Consultant II Job Number : 2025-48325
Category : Administrative Professional
Location : Shrewsbury, MA
Shift : Day
Exempt / Non-Exempt : Exempt
Business Unit : ForHealth Consulting
Department : ForHealth Consulting - Third Party Liability - W401920
Job Type : Full-Time
Salary Grade : 46
Union Code : Non Union Position -W60- Non Unit Professional
Num. Openings : 1
Post Date : June 27, 2025
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.
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.
UMass Chan Medical School was among 23 companies that stood out as 2023 “DEI champions,” according toThe Boston Globe.
Named a U.S. News & World Report
2023 BEST MEDICAL GRAD SCHOOL”
for Primary Care and Research
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Medicaid Eligibility Consultant Ii • Shrewsbury, England, United Kingdom