The Senior Consultant / Advisor provides strategic direction and guidance in the operations and planning of the Payment Error Rate Measurement (PERM) program developed by the Centers for Medicare and Medicaid Services (CMS). Working closely with the Project Director, Task Managers and the CMS, this position seeks to strengthen the program and to mutually benefit stakeholders.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Essential duties and responsibilities include the following. Other duties may be assigned.
Responsible for the integration of CNI Core Competencies into daily functions, including: commitment to integrity, knowledge / quality of work, supporting financial goals of the company, initiative / motivation, cooperation / relationships, problem analysis / discretion, accomplishing goals through organization, positive oral / written communication skills, leadership abilities, commitment to Affirmative Action, reliability / dependability, flexibility and ownership / accountability of actions taken.
Provides ongoing support and guidance concerning critical PERM issues.
Identifies areas of vulnerability and high priority areas for improvements.
Identifies opportunities and challenges within the PERM program.
Advises on key issues and policy utilizing in-depth knowledge and expertise with Medicaid and CHIP programs.
Plans daily activities within the guidelines of company policy, job description and supervisor's instruction in such a way as to maximize output. Responsible for aiding in own self-development by being available and receptive to any training made available by the company.
Responsible for keeping own immediate work area in a neat and orderly condition to ensure safety of self and coworkers. Will report any unsafe conditions and/or practices to the appropriate supervisor and Human Resources. Will immediately correct any unsafe conditions as the best of own ability.
Bachelor’s degree in a related field of study and a minimum of five (5) years relevant experience in a managerial capacity with responsibility for providing supervisory direction to a large and diverse healthcare organization. Supervisory / Managerial / Advisory experience related to project oversight, directing and overseeing the mission-critical work and activities required.
Master’s degree preferred.
Senior level experience advising on identified operational and policy issues and trends, making recommendations for optimizing operational collaboration, efficiencies, and effectiveness required. Five (5) years of consulting and advising in Medicaid and/or CHIP at the state or national level preferred.
JOB SPECIFIC KNOWLEDGE / SKILLS / ABILITIES
Operational knowledge and understanding of improper payment programs and government consulting
Advanced working knowledge of the Medicaid and CHIP programs as well as related coverage and payment rules
Proven ability to take initiative, lead teams, manage risks, bring about strategic change (both within and outside the organization), and to successfully meet organizational goals
Thorough understanding of information technology security and Health Insurance Portability and Accountability Act (HIPAA) policies for dealing with Personal Health Information and personally identifiable information
Demonstrated ability to develop and apply comprehensive solutions to client requirements / issues
Exceptional consultation and advisory skills with ability to oversee large projects and to develop foundational and operational support for projects
Adept analytical, critical thinking and financial management skills
Skilled proficiency in the use of Microsoft Windows and Office programs (i.e., Word, Excel Outlook, Project, SharePoint, etc.)
Exceptional organization skills with ability to effectively manage multiple projects and priorities
Skilled in facilitating teamwork and coordinating efforts for the successful achievement of goals
Excellent supervisory and management skills with ability to resolve conflicts, grievances, confrontations or disagreements in a constructive manner
Excellent verbal and written communications skills with solid presentation skills
Ability to schedule, plan and lead meetings
Exceptional customer service skills with ability to build positive, professional relationships
Ability to implement a proactive approach to problem-solving
Ability to interact professionally with team members, corporate management, and clients of all levels
Demonstrated ability to work under pressure and to meet tight deadlines
Demonstrated ability to effectively work both independently and in a highly collaborative, team environment
CERTIFICATES, LICENSES, REGISTRATION
Must be able to obtain government security clearance.
US Citizens / Green Card only due to government or federal requirement
Ability to read, analyze and interpret common scientific and technical journals, financial reports, and legal documents. Ability to respond to common inquiries or complaints from customers, regulatory agencies, or members of the business community. Ability to write speeches and articles for publication that conform to prescribed style and format. Ability to effectively present information to top management, public groups, and/or boards of directors.
Ability to work with mathematical concepts such as probability and statistical inference, and fundamentals of plane and solid geometry and trigonometry. Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.
Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.