Stay attuned to federal policy changes impacting Medicaid operations and synthesize project information to support APD budgets and narrative development.
Provide expert guidance on APD processes, funding strategies, and compliance considerations while managing priorities across multiple engagements.
Lead client, vendor, and internal team meetings and present findings and recommendations to executive-level stakeholders.
BerryDunn is a client-centered professional services firm providing tax, advisory, and consulting services to businesses, nonprofits, and government agencies since 1974. The firm emphasizes a diverse and inclusive workplace culture with a focus on learning and development.
Lead and support Medicaid Enterprise System initiatives, including system modernization, vendor oversight, and program advisory for U.S. territory and state agencies.
Manage complex multi-stakeholder environments, including government entities, system integrators, and federal partners, ensuring delivery quality and stakeholder alignment.
Provide subject matter expertise in Medicaid domains such as eligibility, enrollment, claims, and financial management, and contribute to key deliverables like ConOps and APDs.
BerryDunn is a client-centered, people-first professional services firm providing tax, advisory, and consulting services to businesses, nonprofits, and government agencies. Since 1974, they have grown to serve clients throughout the US and its territories, led by CEO Sarah Belliveau and recognized for their inclusive workplace culture and focus on learning and well-being.
Lead the organization's strategic response to federal Medicaid changes, including becoming a Qualified Entity in eligible states.
Oversee implementation of SOAR training and medical frailty documentation protocols across all operating states.
Develop tracking systems and evaluation frameworks for coverage retention, redetermination, and SSDI/SSI enrollment outcomes.
GRT provides substance use disorder treatment and support services, including Medicaid enrollment assistance and recovery programs. The company operates in multiple states with a remote workforce, fostering a culture of collaboration and urgency in addressing complex healthcare challenges.
Lead delivery of project-level initiatives or major workstreams within MES programs, including planning, execution, and monitoring of scope, schedule, and deliverables.
Serve as a primary day-to-day client interface for assigned projects or workstreams, ensuring clear communication and alignment with client stakeholders.
Coordinate across vendors, system integrators, and internal teams to support effective execution in multi-stakeholder environments.
BerryDunn is a client-centered, people-first professional services firm providing tax, advisory, and consulting services to businesses, nonprofits, and government agencies throughout the US and its territories. The firm has been recognized for creating a diverse and inclusive workplace culture and focuses on learning, development, and well-being.
Coordinates and administers privacy and compliance programs to ensure adherence to regulatory requirements.
Partners with internal teams to interpret requirements, implement compliant solutions, and monitor activities.
Develops policies, tracks corrective actions, and supports audits to maintain program effectiveness.
Capital Blue Cross is a health insurance company that improves the health and well-being of members and communities. It is an independent licensee of the Blue Cross Blue Shield Association and has been voted a 'Best Place to Work in PA' by employees.
Shape and govern multi-state licensure and regulatory compliance for non-clinical home care operations.
Define strategy, operating model, and governance framework for compliant state expansion and ongoing readiness.
Translate complex state regulations into actionable operational requirements supporting scalable service delivery.
This partner company is a high-impact healthcare organization focused on improving care delivery and outcomes. It operates in a fast-scaling, mission-driven environment with a remote-first work culture.
Own the code block expansion calendar, tracking production, review, and shipping timelines.
Coordinate across clinical leads, protocol specialists, and engineering to sequence dependencies and meet throughput targets.
Manage the policy change queue, ensuring updates are published within SLA, and run weekly CoE standups.
Hike Medical is building the defining company in musculoskeletal care, combining AI, robotics, and healthcare to produce custom 3D-printed orthotics and automate DME workflows. With $22M raised from top-tier investors and a $50M run rate goal by 2026, they run a fast, results-first, high-ownership culture out of their SF Rincon Hill office.
Own HIPAA-compliant source-of-truth artifacts governing Medicare claims business rules.
Validate changes internally and communicate updates to external CMS stakeholders.
Bridge product and engineering by translating policy needs into clear requirements.
Nava is a consultancy and public benefit corporation working to make government services simple and effective. Since 2015, they have helped federal, state, and local agencies solve technology modernization challenges, and they are a remote-first team with a collaborative culture.
Lead a team of regulatory professionals to monitor and operationalize federal and state healthcare regulations for HealthEdge Source™.
Oversee workload distribution, delivery, and escalation management to ensure compliance with complex regulatory landscapes.
Partner cross-functionally with Product, Engineering, and Client Success to integrate regulatory requirements into product development.
HealthEdge is a healthcare technology company that provides reference data and pricing transparency platforms. The company is a full-time, permanent employer with a remote workforce, committed to diversity and offering a collaborative culture.
Support day-to-day delivery across multiple provider engagements, managing tasks, timelines, research, and deliverables.
Analyze legislation, regulations, and payment policy to assess business impacts and strategic implications for provider clients.
Conduct rigorous qualitative and quantitative research, including market scans, competitive analysis, and financial modeling.
ATI Advisory is a healthcare research and advisory services firm that helps businesses, communities, and public programs serve complex populations through original research and practical solutions. With a team of nationally recognized experts, we are a collaborative organization focused on transforming health care across Medicare, Medicaid, long-term care, and provider delivery.
Lead and mentor the Service Delivery team in all Tier 1 and 2 consulting initiatives, providing product education and subject matter expertise on healthcare payment methodologies and operations.
Manage escalated client issues by acting as a liaison between clients and internal support teams to ensure accurate problem resolution.
Develop and maintain capabilities and tools, conduct scoping sessions, and collaborate with cross-functional teams to enhance client outcomes.
HealthEdge is a healthcare technology company specializing in payment integrity and claims adjudication software. The company prides itself on a collaborative, user-driven culture with a focus on impact over ego.
Plan, develop, and direct all aspects of onshore and offshore BPaaS activities to ensure operational efficiency and customer success.
Establish operational objectives, policies, and procedures in compliance with contracts and regulations, and develop strategies to achieve key performance measures.
Provide executive-level briefings to senior leadership and build collaborative relationships with client leadership to drive continuous improvement.
UST HealthProof is on a mission to reshape healthcare insurance by reducing administrative costs and building better healthcare experiences for health plans and their members. The company is run by leaders with strong health plan and technology backgrounds, fostering a supportive, start-up-like environment that nurtures individual growth.
Own Brightline's public-sector growth pipeline, developing strategic pursuit plans and independently originating new opportunities.
Lead complex procurements and contract negotiations, coordinating cross-functional teams and external stakeholders.
Build trusted relationships with senior government leaders and drive revenue growth through new and expanded partnerships.
Brightline is a leading pediatric behavioral health company delivering evidence-based mental health care to children, adolescents, and families through a hybrid model of virtual and in-person services. Founded in 2019, the company has served tens of thousands of families and is backed by investors like Boston Children's Hospital and Google Ventures, with a culture focused on diversity, equity, and inclusion.
Define and lead the end-to-end client and family engagement strategy to drive retention and continuity of care.
Oversee the full client journey from intake through discharge, ensuring a seamless experience.
Act as senior escalation point for complex, high-need cases requiring advanced empathy and problem-solving.
The company is a high-impact digital health environment focused on meaningful healthcare impact. It is a remote-first organization with a mission-driven, collaborative culture emphasizing innovation in care delivery.
Support client engagement and program success, ensuring smooth launches and tracking milestones.
Analyze program performance against key metrics, building reports and dashboards for insights.
Serve as a trusted point of contact for clients, collaborating cross-functionally to resolve issues.
PHIL is a Series D health-tech startup that transforms prescription fulfillment between doctors, pharmacies, and patients. Their team is mission-driven, analytical, and diverse, focused on patient experience.
Lead the full credentialing and recredentialing process for W-2 clinicians across multiple states and payer networks.
Develop and maintain credentialing policies aligned with NCQA, CMS, and state-specific guidelines.
Partner with recruiting, clinical operations, legal, and finance to ensure efficient onboarding and regulatory compliance.
Headlight is a mental healthcare company founded by psychiatrists, transforming access to care and delivery methods for clinicians. They are a growing organization with a collaborative culture, focusing on innovation and whole-person care.
Lead all medical records and release of information operations, ensuring compliance with HIPAA and state regulations.
Design and implement scalable HIM workflows, policies, and tracking systems to improve efficiency and accuracy.
Partner with Compliance, Legal, Clinical Operations, Technology, and Quality teams to support organizational growth.
Backpack Healthcare transforms access to behavioral healthcare for children, adolescents, and families. As a fast-growing company expanding across multiple states, we focus on building scalable systems and fostering a collaborative, mission-driven culture.
Lead client engagements as a trusted thought partner, managing multiple projects and mentoring junior team members.
Provide deep expertise in Medicare Advantage strategy, including go-to-market, coverage decisions, and operationalization across STARS, risk adjustment, and performance management.
Build client relationships and contribute to business development through scoping calls, proposal writing, and cultivating new clients.
ATI Advisory is a healthcare research and advisory services firm focused on transforming how businesses, communities, and public programs serve complex populations. Their team includes nationally recognized experts across Medicare, Medicaid, long-term care, and provider delivery.
Prepare materials for ACO board meetings and coordinate key events for providers and field teams.
Assist in designing and implementing financial and KPI reports using business intelligence tools.
Monitor compliance activities and support special projects and data requests as needed.
Aledade empowers independent primary care practices to thrive in value-based care. Founded in 2014, it is the largest network of independent primary care in the US, with a collaborative, inclusive, and remote-first culture.
Coordinate and support CMS Hospital Quality Reporting Program activities, including work plans, timelines, and contractor oversight.
Develop training materials, presentations, and reports while facilitating cross-functional meetings and stakeholder communication.
Identify workflow improvements using AI tools in accordance with data privacy and quality standards.
HSAG is a healthcare consulting firm dedicated to improving the quality of healthcare delivery in the United States. As a growing team, we foster a collaborative culture focused on making healthcare better for everyone while having fun at work.