Medicaid Policy and Regulation Analyst

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

📋 Description

• Conduct research, comprehend, and articulate Federal and State regulations and policies associated with the administration of State Medicaid programs in the northeastern region.

• Act as a subject matter expert on State Medicaid programs and their specific state-related nuances.

• Collaborate with the broader Medicaid team on research and educational initiatives, project development, and referrals.

• Communicate policy and regulations effectively through written documentation, discussions, or presentations.

• Contribute written policy insights for inclusion in Analytical Findings Reports.

• Work alongside Project Coordination and Data teams to pinpoint projects.

• Identify potential vulnerabilities in programs arising from policy research.

• Participate in policy discussions with states within the jurisdiction.

• Engage in policy discussions with CMS.

• Monitor emerging issues and trends that may impact State Medicaid programs.

• Assist the Medicaid Operations Lead with special research initiatives.

• Manage and annually review the Medicaid Policies & Procedures Manual, updating it as necessary.

• Track policy workload and provide monthly reports to the Medicaid Operations Lead.

• Coordinate state meeting agendas and minutes in collaboration with the Business Analyst.

⛳️ Requirements

• 5 years of experience with a BS/BA or 9 years with a high school diploma.

• Minimum of 5 years’ experience in policy research and analysis.

• Capability to present and discuss state policies and regulations in relation to project impacts.

• Proficient in researching policies and interpreting regulations and regulatory guidelines.

• Strong interpersonal skills with the ability to work independently and collaboratively in a team setting.

• Excellent planning and organizational abilities.

• Exceptional oral and written communication skills; able to effectively communicate and present to all levels of management and associates throughout the organization.

• Ability to meet deadlines and manage multiple customer service demands while maintaining service excellence.

• Adaptability to changing priorities; self-motivated and energetic attributes are preferred.

• Proficient in Microsoft Office applications, including Word, Excel, Access, PowerPoint, and Outlook.

• US citizenship is required.

• Preferred experience with CMS programs, including Medicaid and Medicare, for competitive candidates.

• Preferred experience with Managed Care programs for competitive candidates.

• Knowledge of CMS regulations related to State Medicaid programs, including waivers, is preferred for competitive candidates.

• Familiarity with CMS 64 and the ability to analyze and interpret reports to identify trends and vulnerabilities is preferred for competitive candidates.

• Understanding of the Federal Matched Assistance Program related to State Medicaid programs is preferred for competitive candidates.

• Medical coding knowledge/experience related to Medicare/Medicaid claims is an advantage.

🏝️ Benefits

• Telework options available from all states and time zones.

• Potential eligibility for overtime.

• Potential eligibility for shift differentials.

• Potential eligibility for a discretionary bonus.

• Commitment to equal opportunity employment, including protections for individuals with disabilities and protected veterans.