Associate Director, Healthcare Finance – Medicaid Strategy, Managed Care, Policy, Reimbursement

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee client engagements at Sellers Dorsey that concentrate on Medicaid strategy and financing, managed care, and provider policy and reimbursement.

• Deliver direct consulting and leadership services in healthcare policy, strategy, and management to clients.

• Assist Directors and Senior Strategic Advisors in providing healthcare consulting services.

• Manage senior-level client relationships and handle all policy and technical dimensions of projects.

• Provide strategic advice and guidance to business partners, states, private entities, associations, and unions.

• Offer policy direction, project management, client deliverables, and ensure client satisfaction.

• Identify opportunities for new and expanded business activities.

• Engage with client financial leadership, including CFOs and Reimbursement Directors.

• Recognize reimbursement methodologies and analyze financial records.

• Explore alternative Medicaid financing strategies and formulate recommendations based on regulatory changes.

• Create interactive financial models in accordance with financing structures and state or federal legislation.

• Maintain supporting data and ensure the accuracy of models through rigorous quality assurance processes.

• Securely manage and transfer client data while complying with HIPAA regulations.

• Travel to client locations as necessary.

• Enhance the technical skills of direct reports.

• Execute project tasks and deliver client-ready outputs with minimal supervision.

• Provide subject matter expertise and strategic services across various projects and engagements.

• Conduct primary research and develop solutions.

• Assist with proposals, project planning, data analysis, presentations, and client-facing presentations.

• Act as the primary client contact and primary liaison for technical and financial project elements.

• Collaborate with external client leaders, state government officials, CMS representatives, state actuaries, consultants, trade associations, and other stakeholders.

• Utilize policy and healthcare solution expertise to formulate and communicate solutions.

• Participate in brainstorming and conceptualization workshops.

• Work in conjunction with legal, regulatory, and compliance teams.

• Identify leads and prospects for profitable revenue growth.

• Stay informed about healthcare policies, regulations, and industry developments.

• Assist in drafting proposals, editing, developing project scopes, budgeting, and cost estimation.

• Translate technical information for non-technical audiences.

• Pursue new business opportunities and enhance solutions for existing clients.

• Supervise direct reports, facilitate professional development, manage utilization, optimize resource allocation, and provide constructive feedback.

• Engage clients to understand their challenges and offer Medicaid business solutions and advice.

• Evaluate and refine solutions as Medicaid and healthcare environments change.

• Conduct ad hoc analyses regarding business investments and reimbursement strategies.

⛳️ Requirements

• Bachelor's degree along with 10 or more combined years of experience in public healthcare policy management and/or the healthcare consulting industry.

• 10 or more years of progressively responsible experience in health or human services policy or finance, consulting, and/or in a healthcare service delivery setting, or 5+ years of post-graduate, progressively responsible experience in consulting or operational roles in healthcare and/or health policy research/analysis.

• Capability to develop and effectively present complex data models to both internal and external audiences.

• Proficiency in interpreting and communicating new and existing federal guidelines.

• Leadership and/or people management skills are essential.

• Understanding of Medicaid financing and payment structures.

• Ability to create and design Medicaid payment programs.

• Capacity to evaluate Medicaid payment program constraints, including DSH payments and Fee for Service UPL.

• General knowledge of value-based care and quality considerations.

• Ability to develop and design state-wide or local provider assessment programs.

• Familiarity with CMS submission processes for healthcare taxes and payments.

• Knowledge of State Plan Amendments and Pre-Prints, including submission timelines and data requirements.

• Comprehension of existing CMS rulings and guidelines, as well as the ability to interpret new ones.

• Understanding of allowable sources of non-federal share, including inter-governmental transfers, provider assessments, and certified public expenditures.

• General knowledge of Medicaid Waivers.

• Familiarity with commercial reimbursement principles.

• Experience with healthcare data such as claims datasets and cost reports.

• Experience in developing dynamic models utilizing extensive datasets.

• Knowledge of medical billing terminology and best practices.

• Familiarity with Medicare Hospital Cost Reports.

• Acquaintance with publicly accessible CMS data and other healthcare datasets.

• Understanding of data security and storage principles.

• Ability to mentor and provide guidance to team members.

• Experience with state Medicaid agencies, CMS, or healthcare providers is preferred.

• Proven success in leading teams and managing complex projects.

• High proficiency in Microsoft Word and Excel is required.

• Experience with querying languages such as SQL is preferred.

• Familiarity with approved AI-enabled tools for Medicaid finance research, data analysis, financial modeling, proposal development, and quality review is preferred.

• Validation of AI-assisted outputs for accuracy, regulatory compliance, and client confidentiality is necessary.

• Exceptional oral and written communication skills are essential.

• Ability to analyze and interpret federal and state policies and regulations.

• Capability to interact professionally with clients and external audiences.

• Strong analytical and problem-solving skills are required.

• Experience in quantitative program evaluation is highly desirable.

• Ability to work effectively both independently and within teams.

• Experience delivering services on multiple projects concurrently.

• Strong time management skills are necessary.

• Ability to develop and implement strategies that integrate data analytics and insights into healthcare policy and management decisions.

🏝️ Benefits

• Annual Corporate Incentive Plan (CIP) that can reach up to 15% of annual salary.

• Group healthcare plans providing medical, dental, and vision coverage.

• Short-term disability, long-term disability, and basic life insurance plans.

• 401(k) plan.

• Flexible Time Off policy.

• 16 paid holidays throughout the calendar year.

• Paid time off for qualifying medical leave.

• Up to 12 weeks of combined paid parental and bonding leave.