ForHealth Consulting at UMass Chan Medical School · 2 days ago
Medicaid Eligibility Consultant II
Westborough, MA
Full-time
Hybrid
Mid Level
3+ years expForHealth Consulting at UMass Chan Medical School is seeking a Medicaid Eligibility Consultant II to assist in the development of contracts with state agencies. The role involves conducting complex analyses, supporting Medicaid eligibility initiatives, and contributing to the development of Medicaid systems.
Management Consulting
Responsibilities
Assist in the development of contracts with state agencies; both in and out of state
Conduct complex analysis to support 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
Qualification
Required
Bachelor's Level Degree or equivalent in a business, health policy, social service, or public administration related field
3 to 5 years of experience in a business related field
Extensive and in-depth knowledge of Medicaid policies, programs and procedures and the ability to integrate this knowledge with new and existing IT systems
Familiarity working with complex technical, systems and/or programs issues affecting Medicaid and its services to members
Strong verbal and written communication skills
Must have knowledge of state and federal regulations as they apply to public assistance programs
Demonstrated experience in Microsoft Word, Excel and PowerPoint
Demonstrated project management skills
Ability to travel to the client and/or off-site locations weekly
Company
ForHealth Consulting at UMass Chan Medical School
ForHealth Consulting partners with purposeful organizations, including state Medicaid agencies and health and human services organizations, to make the healthcare experience better for all – more equitable, effective, and accessible.
501-1000 employees
H1B Sponsorship
ForHealth Consulting at UMass Chan Medical School has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (118)
2024 (103)
2023 (105)
2022 (115)
2021 (2)
Funding
Current Stage
Late StageLeadership Team
Carly Gould
Senior Human Resources Business Partner
Jatin Dave
Chief Medical Officer, MassHealth
Company data provided by crunchbase