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- Raleigh, NC
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Sr Consultant, Program Integrity
Public Consulting Group • Raleigh, NC
Posted 9 days ago
PCG Health is seeking a senior consultant to expand and advance our work in Medicaid Home and Community Based Services (HCBS) / and Long Term Services and Supports (LTSS) Oversight and Management. This person would analyze and understand state and federal laws, rules, policies, and programs around Medicaid, and design and implement solutions by which state Medicaid agencies oversee and manage these programs and providers. Functions include, but are not limited to, incident investigation and management, provider audits and reviews, mangaged care contracting and oversight, and provider education and trainings.
Senior Consultants occupy a critical position in PCG and are key to the management team in achieving business objectives. In general, they play one of two roles in the firm. In the consulting practice, they represent an area of expertise essential to one or more product lines. This ability puts them in the position of managing complex projects and/or producing sophisticated deliverables for a number of different projects. Their experience and knowledge of the product lines allows them to train and supervise staff, work independently with minimal supervision, serve as an internal consultant to other projects or product lines, play a key role in proposals and sales presentations, and present at conferences. In operations projects, Senior Consultants may oversee substantial projects involving multiple staff and complex operations. They are often the primary point of client contact and are responsible for managing most deliverables and services. In both cases, Senior Consultants are essential to a product line and have significant practice development responsibilities within the firm. Senior Consultants serve as role models for consultants, business analysts, and administrative staff, always employing sound business and professional judgment in their activities
- Strong quantitative skills and able to analyze and interpret financial data.
- Ability to research, analyze and interpret policy, legal briefs and regulations.
- Able to work independently and consistently achieve excellent results.
- Able to work effectively with all members of project teams.
- Outstanding oral and written presentation skills.
- Demonstrated initiative and the ability to successfully identify new business opportunities.
Bachelors and Masters degrees required
5+ years experience working with Medicaid
5+ years experience working with LTSS/HCBS programs, services, and populations
Previous business development experience required
Previous experience from a consulting firm required
Previous experience with managed care preferred
2+ years supervisory experience required
50% travel required