The Compliance Analyst candidate will work in a deadline-oriented, fast paced environment as part of a growing team consisting of consulting and operations staff. The teams’ goal is to provide superior service to the state Medicaid agency, school districts, and other stakeholders for Medicaid school-based revenue programs. The Compliance Analyst must produce quality work, meet client goals and objectives, and develop solutions to client problems in a timely manner. Compliance Analysts must be able to draw sound conclusions based on data analysis and communicate findings effectively, both in person and in writing. This individual will be assigned short-term and long-term tasks on multiple contracts. As s/he becomes more familiar with PCG clients and product lines, s/he may take on greater responsibility within projects.
This position focuses on the operations delivery of the Medicaid program with major responsibilities to include: conducting validation reviews and drafting final reports; responding to inquiries and questions from various stakeholders; providing user support; drafting presentations; training school district staff on web-based technology applications; and analyzing, formatting and processing data related to Medicaid reimbursement. In addition the Compliance Analyst will provide training support, interpret medical policy and complex provider contracts, manage complex claims, identify/review potential system problems, manage clients, and handle other related duties as necessary.
PCG is a fast paced, energetic environment with dedicated professionals who are passionate and committed to the core values of the organization. Successful candidates must be willing to operate in both a team situation and autonomously with minimal supervision. They must possess strong skills in the areas of interpersonal communication, analysis, critical thinking, attention to detail, multi-tasking, and oral and written communication. Other essential qualifications include:
- A Bachelor’s Degree is a minimum requirement. Preferred in Business Administration, Management Information Systems, Public Administration, Economics, Government, or a related field.
- Strong analytical, interpersonal, organizational, research, presentation, time management, problem-solving.
- Proven ability to take initiative, and move daily work forward with intellectual curiosity, enthusiasm, and eagerness to learn.
- Use problem solving approach to business issues and able to follow, critically evaluate, and improve upon current processes.
- Good judgment in prioritizing and completing tasks, and in seeking guidance when needed.
- Commitment to exceptional client service and contribute in a team environment.
- Core interest in finance, education, health care, government, or public consulting and knowledge of General knowledge or experience in business, or state and local government.
- Dedication to accomplishing goals and challenges presented by clients and management, and accountable for results.
- Ability to interact with various levels of management and with clients.
- Ability to see the big picture while working at the detailed level to move projects forward within specific timeline and budget.
- Helping to complete Medicaid claims and cost reports.
- Managing projects and workplan deliverables on an ongoing basis as well as coordinating business requirements with the team.
- Attending regular clients meetings and working on-site at the client location as necessary.
- Supervising and training staff.
- Conducting financial analysis, resolving claim issues, completing cost reports, and reimbursement projections.
- Preparing, managing, and documenting daily correspondence, written, verbal and e-mail, to clients and their stakeholders.
- Participating on proposal development teams, including writing sections, coordinating efforts, and preparing proposal submissions.
- Defining, documenting, and improving business processes or operational efficiencies.
- Conducting policy and other types of research.
- 3-5 years of relevant work experience.
- Ability to travel up to 50% will be required, including working on site a client locations.
- Ability to work overtime.
This position may be subject to a background check. An EEO, AA, VEVRAA employer.