Health Policy Senior Project Consultant/Advisor

Position Description

Serco is seeking a motivated Senior Project Consultant / Advisor to join our talented and fast-paced Public Sector Solutions team in supporting CMS' implementation of the Payment Error Rate Measurement (PERM) Program to produce national Medicaid and Children's Health Insurance Program (CHIP) improper payment estimates as required by the Payment Integrity Information Act of 2019 (PIIA).

• As part of this effort, Serco would execute the PERM review contract which includes collection of state eligibility policies and medical records;
• medical reviews, data processing reviews, and eligibility reviews of selected state Medicaid and CHIP fee-for-services (FFS) and managed care claims;

and supporting state and national reporting and development of corrective actions based on findings. The Senior Project Consultant / Advisor would be responsible for advising and proactively providing strategic direction and guidance in the operations and planning of the PERM program to strengthen the program and mutually benefit stakeholders.

The candidate in this position ideally brings unique combination of strong program management experience and subject matter expertise in medical records review and claims processing review for the Medicaid and Children's Health Insurance Program.

The position also is responsible for providing on going support for critical issues and program improvements to coordinate and optimize multiple aspects medical and claims review operations.

Hybrid or full-time remote work. This is position is contingent on contract award.

In this role, you will :

• Be in direct communication with the project director, management staff, and CMS as part of management team.
• Proactively provide strategic direction and guidance in the operations and planning of the PERM program to strengthen the program and mutually benefit stakeholders.
• Advise on key issues and policy utilizing in-depth knowledge and expertise with Medicaid and CHIP programs.
• Provide ongoing support and guidance on critical issues, identify areas of vulnerability, identify high priority areas for improvements, identify opportunities and challenges within the PERM program.
• Serve as a point of contact with the CMS SMEs and states on policies, processes, operations, error rate analysis, findings and appeals.

Competencies

• Working experience and in-depth knowledge of Medicaid and CHIP programs and policy;
• Thorough understanding of project / program management techniques and methods with proven management of large government program or contracts.
• Demonstrated knowledge of data analysis, performance evaluation techniques, key metrics and reporting.
• An analytical mindset with problem-solving abilities.
• Strong leadership and organizational skills.
• Excellent communication skills, both strong orally and written skills.
• Exceptional interpersonal skills with ability to establish and maintain effective working relationships.
• Demonstrated good judgment, business acumen with a strategic ability, and the ability to think constructively.
• Ability to deal with complex and changing policy and political environment.
• Enjoy working in fast-paced and collaborative team environment.

Qualifications

Required Qualifications

The Senior Project Consultant / Advisor will possess a combination of experience and education meeting the following criteria :

• A minimum of five (5) years' experience in a managerial capacity with responsibility for providing supervisory direction to a large and diverse health care organization responsibly.
• Senior advisor experience overseeing large projects and developing foundational and operational support for projects, utilizing sophisticated analytical skills;
• Demonstrated ability to bring about strategic change, both within and outside the organization, to meet organizational goals;
• Senior level experience advising on identified operational and policy issues and trends, making recommendations for optimizing operational collaboration, efficiencies, and effectiveness;
• Supervisory / Managerial / Advisory experience related to project oversight, directing and overseeing the mission-critical work, activities, taking initiatives, leading teams, and managing risk;
• Working experience and in-depth knowledge of Medicaid and CHIP programs and policy;
• Preferably five years consulting and advising in Medicaid and / or CHIP at the state or national level; and :
• Holds a Bachelor's Degree or Master's Degree from an accredited university and in a field of study that can be reasonably interpreted to perform tasks related to this position.

If you are interested in supporting our mission and working with a passionate team - then submit your application now for immediate consideration.

It only takes a few minutes and could change your career!

Company Overview

Serco Inc. (Serco) is the Americas division of Serco Group, plc. In North America, Serco's 9,000+ employees strive to make an impact every day across 100+ sites in the areas of Defense, Citizen Services, and Transportation.

We help our clients deliver vital services more efficiently while increasing the satisfaction of their end customers. Serco serves every branch of the U.

S. military, numerous U.S. Federal civilian agencies, the Intelligence Community, the Canadian government, state, provincial and local governments, and commercial clients.

While your place may look a little different depending on your role, we know you will find yours here. Wherever you work and whatever you do, we invite you to discover your place in our world.

Serco is a place you can count on and where you can make an impact because every contribution matters.

To review Serco benefits please visit : https : / / www.serco.com / na / careers / benefits-of-choosing-serco. If you require an accommodation with the application process please email : redacted or call the HR Service Desk at redacted , option 1.

Please note, due to EEOC / OFCCP compliance, Serco is unable to accept resumes by email.

Candidates may be asked to present proof of identify during the selection process. If requested, this will require presentation of a government-issued I.

D. (with photo) with name and address that match the information entered on the application. Serco will not take possession of or retain / store the information provided as proof of identity.

For more information on how Serco uses your information, please see our Applicant Privacy Policy and Notice.

Serco does not accept unsolicited resumes through or from search firms or staffing agencies without being a contracted approved vendor.

All unsolicited resumes will be considered the property of Serco and will not be obligated to pay a placement or contract fee.

If you are interested in becoming an approved vendor at Serco, please email A redacted .

Serco is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics.