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
Internal 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)
External 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)
