PCG is seeking a qualified candidate to work on at least one cost settlement and/or revenue maximization projects relating to programs served by public providers. This individual will work with consultants, business analysts, and operations staff on assigned short-term and long-term tasks on multiple contracts. One of the current projects include processing the cost settlement by conducting desk reviews of Medicaid cost reports submitted by Local Education Agencies (LEAs). Additional tasks include: reviewing expenditure data for outliers, contacting LEAs to support outlier expenditure data, examining the ratios reported by school districts to the paid claims data. Programs, such as the one described above, seek to improve funding mechanisms for the public providers in order to serve the most vulnerable Medicaid patients.
The ability to draw sound conclusions based on data analysis and communicate findings effectively, both in person and in writing will also describe a successful candidate. As they become more familiar with PCG clients and product lines, they may take on greater responsibility within the project team. Ideal clients will have existing knowledge or experience with state government, health care, special education, cost accounting, cost reports. A general understanding of medical billing and healthcare provider reimbursement methodologies are all significant advantages. The candidate must be able to work within a team but also work independently.
This position requires a self-starter who can quickly learn our web-based technologies, adapt to ever-changing market conditions, and lead clients through the implementation and training process. This position focuses on customer service by responding to inquiries and questions from school districts; and to train school district staff on web-based technology applications and services. The Associate Business Analyst analyzes information provided by school districts and conveys issues to PCG software developers to improve existing technology applications. The ideal candidate for this position will be adaptable, flexible, enthusiastic, and have the ability to manage multiple tasks or clients simultaneously.
Conduct policy research on Medicare and Medicaid federal regulations on reimbursement issues;
Assist school districts in submitting data pertaining to Medicaid, using our web-based cost reporting system;
Implement on-going process to collect and analyze required data elements;
Provide audit support for clients;
Train school district users on system updates, requirements for submission of cost reports, and Federal policies on reimbursement;
Assist in the calculation of interim rates for school health related services;
Participate on proposal writing teams, including writing sections, coordinating efforts, and preparing proposal submissions;
Collaborate with key stakeholders in the project process to provide excellent customer service;
Demonstrate effective communication skills in the analysis, design and development of business processes;
Assess provider best practices, monitor program compliance and provide technical assistance to a wide variety of stakeholders and clients;
Assist with preparation of written reports, materials, and financial analysis for clients;
Create and manage client agendas and meetings;
Serve as a system content expert for other staff in PCG.
Minimum requirements for this role include:
Bachelor's degree.Note: ABA’s are a part our college hiring program, thus candidates must have received their Bachelor’s Degree within 12 months of hire.
Strong interest in major policy trends and issues in healthcare reform, Medicaid, finance, education, or government;
Strong verbal and written communication skills;
A background in meeting planning, public speaking and presentation;
Strong analytical skills, including the ability to analyze and organize data.
Qualitative research and analysis skills;
Good time management and attention to detail;
Critical thinking skills;
Self-starter possessing intellectual curiosity.
Good judgment in completing tasks and in seeking guidance when needed.
A commitment to deliver exceptional client service and contribute in a team environment.
Flexibility or willingness to embrace change with workload and travel;
Proficiency in Microsoft Office, particularly Excel, Access, PowerPoint;
Preferred candidates will also have one or more of the following:
Familiarity with the Title XIX, Title XXI, Medicaid, Medicare, and other public programs;
General knowledge of business administration, government, health insurance payment systems, public sector consulting, cost accounting special education are highly desirable;
The ability to analyze and aggregate Medicaid claims data for rate setting purposes using Access and/or SQL Server;
Experience with technical assistance or training.
Additional experience using health-related accounting systems is a plus
This position may be subject to a background check. An EEO, AA, VEVRAA employer.