Subject Matter Expert/ Associate Engagement Director, Medi-Cal/California Medicaid Financing - Remote

Sellers Dorsey is seeking a Subject Matter Expert/Associate Engagement Director working remotely for our California and SME Practices who will assist the team by leveraging deep knowledge of policy and/or financial expertise in areas such as California Medicaid financing and revenue maximization, provider reimbursement (physician, hospital, other), state and federal Medicaid reimbursement policy, healthcare taxes, intergovernmental transfers, and navigating the shift to value-based payment and/or provider operations.  They are responsible for policy guidance, development of financial estimates and understanding state and federal reimbursement systems. 

The Subject Matter Expert/Associate Engagement Director is a key member of the client servicing team, helping implement and manage new programs for clients and ensuring a high level of satisfaction.  In addition to client servicing, the Subject Matter Expert/Associate Engagement Director assists the sales team by identifying new business opportunities, expanding existing engagements and participating in sales activities, including attending prospective client meetings.

Responsibilities/Duties

Consulting Services

• Depending upon specific areas of expertise, assume significant levels of responsibility on a diverse range of projects and project tasks; develop consulting expertise that can be replicated in future projects.
• Manage all technical aspects of Medicaid financing initiatives.
• Perform assigned and agreed upon project tasks maintaining client satisfaction; takes ownership of work and assists in the development of “client-ready” deliverables.
• Deliver subject matter expertise and consulting services for multiple clients/projects, clients and engagements; manage assigned primary research and/or solution development; assist with proposal development, project plan development, data analysis (SQL) and modeling, presentation development, and delivery of client presentations.
• May serve as a key client contact to respond to questions, provide required communications and be responsible for a successful client engagement.

Business Development

• Use personal industry knowledge, connections, business expertise, public policy awareness and political insight to identify leads that could result in profitable revenue growth for the Firm.
• Actively provide proposal development assistance including proposal drafting, editing, scope development, and related duties and participate in sales meetings, as necessary.
• Actively seek to identify new business opportunities for the Firm within assigned clients to help maximize long term benefits and relationship between the client and Sellers Dorsey.
• In coordination with the marketing team, produce and review content for selected internal and external marketing tools, such as Firm newsletters, conference presentations, website content, and marketing webinars, to highlight the Firm’s capabilities, subject matter expertise and successes.

Knowledge Management

• Leverage policy and/or healthcare solution expertise to help the Firm develop, document and communicate new solutions.
• Responsible for keeping current on the changing federal regulatory environment, learning state specific regulations to support assigned projects, and staying current on industry trends.

Required Qualifications:

Education and Work Experience

• Bachelors degree and 10 or more combined years in Medicaid, provider reimbursement and/or in the healthcare consulting industries.
• Experience and understanding of California Medicaid/Medi-Cal financing and payments is a must.
• Experience working with healthcare data such as claims sets, cost reports, etc.
• Experience in Medicaid agency, CMS or healthcare providers preferred.
• Experience with value-based payment arrangements preferred.
• SQL knowledge/experience preferred.

Skills

• Extensive practical knowledge and application of Medicaid reimbursement rules
• Ability to perform all the technical functions of a Medicaid financing initiative including but not limited to:
  • Assess potential Medicaid supplemental payments and related transactions in states where Consultant, Senior Strategic Advisor may not have prior knowledge.
  • Utilize cost reports, disproportionate share (DSH) reports and other large datasets to drive decision points within a project.
  • Determine all the steps needed to execute a Medicaid financing initiative.
  • Provide detailed data analysis (SQL), models and summaries of the financial impact from policy or methodology changes.
  • Calculate upper payment limits for a variety of providers and provider classes under the Medicaid program.
  • Estimate the potential federal funds generated by an initiative as well as the transaction costs.
  • Assess project data needs and collect the data necessary to carry out the above activities.
  • Respond to questions and inquiries by the Centers for Medicare and Medicaid Services (CMS) and keep track of recent CMS decisions and decision-making procedures.
  • Assist clients in developing policies, procedures and structures required to implement the project.
  • Understanding of the connection between reimbursement, quality and value at both the state and provider levels.
  • Provide subject matter expertise related to Medicaid managed care, rate development, and metrics related to clinical or financial measurement.
  • Serve as a mentor to junior staff, leveraging as appropriate to execute client deliverables.
• High proficiency in Microsoft Word, Excel, Access required.
• Simultaneously balance the needs and timeliness of many projects.
• Work closely with the project director and project managers to draft public notices, state plan amendments, 438.6(c) preprints, waiver amendments, memos, workplans, and external or internal progress reports, client-ready spreadsheets and calculations.
• Provide technical leadership and explanation to multiple levels of the organization to build internal capacity and foster knowledge management.
• Excellent oral and written communication skills including relaying complex technical terms in an easy to understand manner. This includes producing written or pictorial materials for external and internal use and to present calculations in a manner that the client or other staff can reasonably follow.
• Ability to interact professionally with clients and other outside audiences.
• Work with legal counsel when necessary in designing new payment initiatives.
• Attention to detail.
• Ability to work independently and in teams.
• Time management skills.