Medicaid Eligibility Subject Matter Expert

Key Role:

Serve as a management team member responsible for oversight and quality assurance for PERM eligibility reviews. Provide Medicaid eligibility policy technical assistance to project team members and state and CMS staff. Apply knowledge of the analysis process for the performance, procedures, and processes of complex systems to improve both efficiency and effectiveness and address priority operational challenges. Advise on the delivery of operational solutions and ongoing performance management to help achieve operational excellence and quality. 

Basic Qualifications:

-5+ years of experience with management
-3+ years of experience in working with state Medicaid and CHIP agencies
-Experience with working on PERM eligibility

-Knowledge of state Medicaid eligibility systems, state Medicaid eligibility determination processes, and state Medicaid eligibility policies

-Knowledge of the principles and practices of Medicaid and CHIP eligibility

-Knowledge of the Affordable Care Act, including comprehension of eligibility

-Ability to interpret Medicaid, CHIP, and state eligibility regulations and analyze their impact on current and proposed programs

-Ability to communicate with government and state stakeholders effectively both orally and in writing

-Ability to establish and maintain effective working relationships

-BA or BS degree

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