Manage forensic reviews, investigative activities, and claims audits related to Medicaid programs to identify fraud, waste, and abuse. Provide oversight for program integrity operations while collaborating with stakeholders to improve internal controls and ensure regulatory compliance.
The Senior Medicaid Analyst will analyze complex healthcare data to identify program risks, improper payments, and operational vulnerabilities. They will develop actionable recommendations and reports to support Medicaid program integrity and performance improvement initiatives.
The Health Economist will design and conduct quantitative analyses to inform Medicaid policy, program integrity, and strategic decision-making. They will lead analytic workstreams, develop economic models, and translate complex findings into actionable recommendations for government leaders.
The Senior Healthcare Data Analyst will analyze complex Medicaid datasets to support policy and program transformation initiatives. They will develop monitoring tools, validate data, and translate findings into actionable insights for decision-makers.
The Medicaid Policy Director will lead consulting efforts to help state Medicaid agencies implement new programs and ensure compliance with federal requirements. They will also engage in business development and mentor team members to foster professional growth and expertise.
The project manager will lead complex Medicaid initiatives, including operational system development and behavioral health program oversight. They are responsible for managing client relationships, developing program recommendations, and mentoring junior staff.
The Senior Consultant will lead attestations and performance audits while assisting with project management tasks such as tracking progress and reviewing deliverables. They will also facilitate meetings with client stakeholders and develop concise reports and presentations for client leadership.
The Senior Consultant will manage permitting and land management system implementations for local government clients while leading project teams and coordinating with vendors. They will also oversee project delivery, facilitate procurement activities, and contribute to business development efforts.
The consultant will participate in governmental accounting and auditing engagements, providing business improvement recommendations and internal control advice. They will also collaborate with team members to plan project activities, manage client expectations, and ensure compliance with auditing standards.
You will lead and implement organizational change management activities for State Medicaid Agency clients during system transformations. You will also act as a trusted advisor to build stakeholder relationships, manage project deliverables, and provide guidance to internal project teams.
Conduct detailed forensic reviews and audits of Medicaid claims to identify fraud, waste, abuse, and operational risks. Collaborate with client staff and internal teams to document findings, improve internal controls, and support recovery efforts.
The Senior Consultant will lead and manage a diverse portfolio of parks, recreation, and library planning projects, including master plans and feasibility studies. They will collaborate with clients and multidisciplinary teams to develop practical, data-driven solutions for public spaces.
Lead actuarial engagements for state Medicaid agencies and public health clients, including the development and certification of actuarially sound capitation rates. Oversee encounter data analytics, risk scoring methodologies, and provide strategic guidance on program design and value-based payment models.
The Proposal Coordinator supports the Business Development team by preparing proposal materials, conducting client research, and developing graphics. They are responsible for maintaining content repositories and ensuring high-quality, responsive submissions under strict deadlines.
The role focuses on redesigning and improving Medicaid eligibility and enrollment business processes using the DMAIC framework. It involves collaborating with stakeholders to translate regulatory requirements into workflows, SOPs, and implementation plans.
Plan, coordinate, and execute UAT activities for system enhancements and Medicaid modernization efforts. This includes developing test scripts, tracking defects in Jira, and communicating outcomes to stakeholders to ensure release readiness.
The SME provides expertise on federal and state Medicaid requirements to support compliance monitoring, audit readiness, and risk mitigation. They collaborate with cross-functional teams to translate policy interpretations into actionable operational improvements and system enhancements.
The Business Analyst will support Hawaiʻi Med-QUEST's program integrity and claims review initiatives through discovery, policy analysis, and workflow development. They will collaborate with stakeholders to translate data findings into clear recommendations and implementation supports for operational improvements.
Lead Medicaid program integrity activities focusing on fraud, waste, and abuse prevention, provider oversight, and claims audits. Establish foundational processes and operational rigor to stabilize the Program Integrity unit and transition it to client ownership.
The Business Analyst will conduct discovery and current-state analysis to redesign business processes and support H.R.1 implementation for Hawaiʻi Med-QUEST. They will develop workflow maps, SOPs, and implementation materials while coordinating with stakeholders and project leadership.
Manage full-cycle recruitment for experienced consulting professionals across various practices, including healthcare and government sectors. Partner with hiring managers to develop sourcing strategies and utilize behavioral assessments to ensure cultural and technical fit.
Lead and support IT strategy, modernization, and governance initiatives for state government clients. Develop implementation roadmaps, conduct management assessments, and facilitate stakeholder workshops to improve technology services.
Lead technology assessments, strategic planning, and modernization initiatives for state government clients. Develop actionable roadmaps and operating models to improve IT service delivery and align technology investments with enterprise goals.
Conduct strategic HR and organizational assessments to transition HR functions from administrative tasks to strategic business partnerships. Develop actionable deliverables, implementation roadmaps, and facilitate leadership briefings to improve operational effectiveness for state government clients.
Lead and manage multiple tax engagements while advising clients on tax implications and compliance strategies. Participate in regional leadership, marketing, and business development to grow the service base.
The Audit Senior will lead healthcare client engagements from planning to completion, focusing on audits, reviews, and compilations for hospitals and senior living facilities. They are also responsible for supervising and mentoring associates and interns while providing business improvement recommendations to clients.
Lead and support the delivery of complex Medicaid Enterprise System (MES) modernization initiatives for HHS agencies, primarily in Puerto Rico. This includes managing vendor performance, coordinating multi-stakeholder environments, and developing key strategic deliverables like MES Roadmaps and RFPs.
Lead the delivery of Medicaid Enterprise System (MES) projects and workstreams for State Medicaid Agencies and HHS clients. Coordinate across multi-vendor environments to ensure outcomes are achieved on time, within scope, and aligned with program objectives.
Serve as the primary intake and coordination lead for client priorities, translating needs into actionable workstreams for the Territory of Guam's DPHSS. The role blends strategic project management with OCM to ensure readiness, adoption, and sustainability of transformational efforts.
Lead and deliver complex healthcare data management and system technology initiatives using a hybrid Agile and traditional project management approach. Act as a liaison between business stakeholders and technical teams to translate needs into functional specifications and oversee the full SDLC.
Lead and manage multiple tax engagements while advising clients on tax implications and compliance strategies. Act as a primary client contact and participate in regional leadership, marketing, and business development efforts.
Responsible for all aspects of provider and group enrollment, credentialing, and re-credentialing, including CAQH activities and primary source verification. The role involves maintaining credentialing databases and coordinating with payers and client liaisons to ensure contractual obligations are met.
Lead client policy initiatives for state Medicaid agencies, focusing on the implementation and redesign of home and community-based services (HCBS). Responsibilities include policy analysis, facilitating client meetings, and managing project deliverables and reporting.
The consultant will advise state Medicaid agencies on policy initiatives, conduct research, and produce written policy content such as briefs and compliance analyses. Additionally, they will support business development and mentor junior staff members.
Lead the implementation of utility billing and customer information systems for local government clients, managing both internal and vendor teams. Responsible for delivering services on time and within budget while facilitating decision-making and participating in business development activities.
You will lead Medicaid initiatives focused on waiver and state plan amendment design, development, and implementation while managing client relationships and project deliverables. Additionally, you will mentor junior staff, drive business development activities, and provide subject matter expertise to state Medicaid agency clients.
The consultant will lead and support Medicaid agency clients by providing subject matter expertise on program policy, 1915(c) waivers, and project management. Responsibilities include developing client deliverables, managing stakeholder relationships, and participating in business development activities.
Lead project teams in providing IT system planning, procurement support, and business process improvement for state Health and Human Services agencies. Manage project delivery, develop key deliverables, and serve as a trusted advisor to client executive leadership.
The consultant will provide organizational development services to clients undergoing transformation to align with their business strategy, acting as a trusted advisor to guide clients and internal teams. Key activities include facilitating group discussions, creating organizational analyses using diagnostic tools, designing leadership development programs, and facilitating change management strategies.
