Medicaid Senior Consultant

About the role

The Medicaid Senior Consultant supports the Medicaid Market Office by providing first‑level analysis, interpretation, and execution support for Medicaid contractual, regulatory, and policy requirements. The role acts as a bridge between strategy, operations, and compliance, ensuring timely and accurate implementation of regulatory initiatives.

Key responsibilities

• Analyze and interpret Medicaid contract provisions, ASES circulars, guidance, and regulatory requirements, translating them into practical operational actions.
• Coordinate timelines, dependencies, and deliverables across functions to support implementation of regulatory and contractual initiatives such as payment model changes and reporting requirements.
• Prepare draft responses, summaries, and implementation guidance for leadership review.
• Serve as the first‑level analytical filter for routine regulatory and contractual inquiries, escalating higher‑risk issues to Compliance or Legal.
• Monitor regulatory developments, assess operational, financial, and compliance impacts, and track implementation progress and risks.
• Support creation and maintenance of process documentation, playbooks, and reference materials to promote consistency in regulatory interpretation.

Required profile

• Bachelor’s degree in Business Administration, Health Administration, Public Health, Public Policy, Law (non‑litigative) or a related field.
• 4–7 years of experience in Medicaid, healthcare operations, regulatory analysis, or similarly highly regulated environments.
• Project Management Professional (PMP) certification preferred.