Senior Consultant, Healthcare Finance (Healthcare & Medicaid Finance and Analysis)

Overview

This role supports healthcare finance consulting engagements by partnering with project leadership and engagement managers to deliver timely, effective analysis and implementation of healthcare financing and quality improvement initiatives. Responsibilities include building and interpreting complex financial models, data analytics, and processes that inform service delivery and client satisfaction, with a focus on standardization at key project stages.

Responsibilities

• Create models and projections using multiple data sources; clearly communicate model assumptions, limitations, and potential shortcomings. Identify and discuss additional data or information needs with project teams.
• Interpret Medicaid State Plan Amendments to recreate or reverse engineer existing supplemental payment models.
• Research and interpret state regulations, rules, and SPAs to recreate models, programs, and payment estimates.
• Quickly analyze existing Excel models to recreate or duplicate prior-year methodologies.
• Recreate complex calculations (including IGT and tax models) using limited information from PDFs, rules, and other available documentation.
• Respond to detailed CMS questions related to models, calculations, and numbers included with Preprint submission—covering both original preprint components (e.g., table 2) and additional documents.
• Train and communicate program details to new team members and onboarded employees, including translating complex calculations for non-Subject Matter Experts (SMEs) and supporting new SMEs as they ramp up.

Essential Functions

• Create tailored data requests based on project and client needs; review received files for quality and completeness and provide feedback. Lead discussions on concerns and required revisions.
• Serve as the primary resource for cleaning, organizing, and linking multiple data sources to establish a comprehensive client data set, including client-provided data as well as publicly available third-party or government sources.
• Support the sales lifecycle by participating in assessments and calculating high-level financial estimates to guide early project development.
• Lead creation and maintenance of dynamic financial models using client data; drive iterative model optimization, present model options to project teams, and clearly explain benefits and risks.
• Monitor CMS and state Medicaid policy and regulation developments and interpret national, state, and local policies and payments to inform and direct financial modeling.
• Advise on technical components of client deliverables, including PowerPoint presentations or one-page documents.
• Assist in completion of preprint, waiver, and other required documentation; collaborate with the project team on CMS communications as needed.
• Prepare project management teams for client engagements with in-depth demonstrations of data deliverables; communicate technical concepts to non-technical audiences. Participate in and lead as needed during project engagements.
• Create and maintain firmwide resources that support the sales process, including national modeling and data request templates.
• Support development of firmwide training opportunities across a variety of healthcare finance topics (Medicaid Finance, GME, billing, Ambulance).
• Other duties as assigned.

Requirements

• Bachelor’s degree required.
• Microsoft Word proficiency and advanced Excel required.
• Strong oral and written communication skills, including explaining complex technical concepts in easy-to-understand terms for technical and non-technical peers.
• Strong ability to research, analyze, and interpret financial data drawn from multiple healthcare-related sources.
• Ability to interact professionally with clients and external audiences.
• Strong analytical and problem-solving skills.
• Ability to work independently and in teams.
• Ability to deliver services on several projects simultaneously.
• Time management skills.

Preferred Qualifications

• Advanced degree in Public Policy, Public Administration, Public Health, Health Administration, business, economics, Mathematics, Accounting, or MBA Statistics.
• Master’s degree in mathematics or accounting would be a plus.
• CPA certification and/or advanced training in actuarial science.
• Expertise in Medicaid.
• Advanced experience in federal or state government or private healthcare industry.
• Experience with SQL, SAS, or other data languages.
• Expertise in healthcare billing, claims work, or other healthcare data-related fields.

Experience

• 7-10 or more years of progressively responsible work experience in a technical capacity in health or human services policy research, consulting and/or in a healthcare service delivery environment, or
• 5+ years of post-graduate, progressively responsible work experience in consulting or operational experience in health care and/or health policy research/analysis.
• Experience should primarily be in a technical capacity such as data analytics, claims analysis, financial analysis, or similar.

Compensation & Benefits

• Anticipated salary range: $95,800/year to $130,000/year (lowest geographic market range to highest geographic market range).
• Final pay will depend on factors including type and years of experience, type of industry experience, education, and market location.
• Annual Corporate Incentive Plan (CIP) eligibility: up to 9% of annual salary.
• Group healthcare plan eligibility (medical, dental, and vision) and insurance plans offering short term disability, long term disability, and basic life (eligibility determined by plan documents).
• 401(k) plan eligibility for employees who meet plan requirements.
• Flexible Time Off.
• 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.

Other Requirements

• Applicants must be authorized to work in the United States.
• Employment is contingent upon successful completion of a background check.
• Drug-Free workplace.

Location

United States (no additional location details provided).