Medicaid Program Advisor

Staffing Solutions Organization LLC (SSO), an affiliate of Public Consulting Group LLC (PCG), is focused on delighting clients with world-class managed staffing and talent consulting services. SSO is committed to a diverse workforce, which is a reflection of our clients and the people they serve.

Medicaid Program Advisor, Albany NY

DHPC0 - 1061

Summary

This individual will assist the Department of Health’s Office of Health Insurance Programs (OHIP)/Division of Health Plan Contracting and Oversight (DHPCO) in development, analysis and oversight associated with the Medicaid Managed Care Operating Cost Reports for Medicaid and Managed Long Term Care (MLTC) plans, Medical Loss Ratio Reporting and Oversight as well as overall plan solvency.

Basic Qualifications:

• Assist in the development of quarterly financial reports to collect financial information from the Medicaid Managed Care Organizations (MCOs) in NY inclusive of Medical Loss Ratio reporting and oversight.
• Review and oversee timely filing and accuracy of all MCOs financial reporting (MLTC and Mainstream Plans).
• Conduct reviews of MCOs financial reporting and operating status, including compliance with Public Health Law, regulations and policies as well as the federal regulations.
• Communicate findings and collaborate with MCOs to improve accuracy of financial reporting
• Review and Evaluate plan Solvency.
• Review and evaluate MCO expansions, mergers and acquisitions for MLTC and Mainstream plans.
• Assist in automating and standardizing financial reports for analysis of fiscal status of the MCO
• Develop ad-hoc financial reports extracting data, as necessary.
• Review and evaluate MCO provider and management contracts for compliance with the financial standards and requirements in PHL.
• Expect to supervise 1-2 staff as unit grows.

Desired Qualifications

• Strong Excel and data analytics skills. 

• Strong communication skills (written and oral).

• Ability to present data to parties with varying backgrounds.

• Ability to work independently.

Education:

• Bachelor’s degree in business, finance, accounting, or related field. 
• Eight (8) years of work history in finance or healthcare.