Healthcare Innovations Functional Consultant/SME

Remote Full-time
About the position GDIT is searching for a dynamic healthcare administration and policy Sr. Advisor to join our growing Federal Health team. You will support an exciting new program focused on vulnerability risk assessments for the Centers for Medicare & Medicaid Services. The role will allow you to utilize in-depth knowledge of Medicare, Medicaid and Managed Care policies, systems, payment structures, risk adjustments processes, including claims and data analyses. You will conduct high-level research and analyses to identify opportunities for advancement and improvement in healthcare regulations and payment guidelines with a focus on developing recommendations for efficiencies, innovation, and strategies to reduce or prevent future risk. Responsibilities • Conduct advanced research, analysis, and investigative activities to assess program risk related to Medicare and/or Medicaid managed care policy, payments, and regulatory requirements. • Lead a team dedicated to the assessment of complex requirements, processes, systems, and guidelines to identify opportunities for innovation, efficiencies, and improvements. • Lead a team of research analysts in completing a comprehensive assessment of risk, documenting and presenting findings to senior executives and our customers. • Work collaboratively with a team of data, clinical, and research analysts to efficiently assess complex guidelines and accurately prioritize risk based upon quantitative and qualitative findings. • Synthesize complex policy and regulatory guidance to develop recommendations, both written and verbal, to present to senior leadership. Requirements • Bachelor's degree or Master's degree in Healthcare Policy, Healthcare Administration or related field, or equivalent experience. • Minimum of 10 years conducting systems, regulatory or policy research related to Medicare and/or Medicaid. • Significant in-depth experience with Centers for Medicare and Medicaid programs, coupled with a deep customer intimacy. • Experience documenting and presenting complex studies and analyses to a wide audience including senior Agency leadership. Nice-to-haves • Medicare Advantage or Medicaid Managed Care experience is preferred. • Ability to conceptualize, solve problems and draw conclusions. • Highly organized, ability to multi-task and meet deadlines. • Strong inter-personal and communications skills, both written and oral. • Proficient in computer skills, e.g. Microsoft Office-Word, Excel. Benefits • Variety of medical plan options, some with Health Savings Accounts. • Dental plan options. • Vision plan. • 401(k) plan with company match. • Full flex work weeks where possible. • Paid time off plans including vacation, sick and personal time, holidays, paid parental, military, bereavement and jury duty leave. • 15 days of paid leave per calendar year. • 10 paid holidays per year. • Paid Family Leave program providing up to 160 hours of paid leave in a rolling 12 month period. • Short and long-term disability benefits. • Life, accidental death and dismemberment, personal accident, critical illness and business travel and accident insurance. Apply tot his job
Apply Now

Similar Opportunities

Regulatory Affairs Consultant - Advertising and Promotion

Remote Full-time

Sr. IT Quality Assurance Analyst

Remote Full-time

Field Clinical Practice Consultant RN

Remote Full-time

FDA Regulatory Consultant for Class II Medical Device Compliance

Remote Full-time

Quality Specialist (Health Care)

Remote Full-time

Business Compliance Consultant

Remote Full-time

Quality Consultant (Health Plan) (Remote) Job at UnitedHealthcare in West Palm Beach

Remote Full-time

Senior Regulatory Consultant; NA and LATAM

Remote Full-time

FDA Regulatory Strategy Consultant – Laser Cap Medical Device Development

Remote Full-time

Lead Healthcare QA Manager Need 12+ years Exp

Remote Full-time

HR GENERALIST - United Airlines Lounges - DENVER, CO in Denver, CO

Remote Full-time

**Experienced Remote Data Entry Specialist – Flexible Part-Time Opportunities at blithequark**

Remote Full-time

HEDIS Clinical Quality Analyst (Full-time Remote, North Carolina)

Remote Full-time

Field Membership Specialist (NC)

Remote Full-time

**Experienced Senior Estimator – Capital Budgets and Project Management for Disney Glendale**

Remote Full-time

Experienced Remote Customer Support Specialist - Live Chat Helpline Assistant for Innovative Home Decor and Furniture Solutions at blithequark

Remote Full-time

Principal Engineer- Java Business Process Mode (JBPM)

Remote Full-time

Integrations & Technical Support Specialist (Remote)

Remote Full-time

**Experienced Customer Service Representative – Healthcare Industry – Remote Work Opportunity at blithequark**

Remote Full-time

Regional Vice President (RVP) Provider Solutions

Remote Full-time
← Back to Home