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Public Consulting Group LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies to improve lives. Founded in 1986, PCG employs approximately 2,000 professionals throughout the U.S.—all committed to delivering solutions that change lives for the better. The firm is a member of a family of companies with experience in all 50 states, and clients in three Canadian provinces and Europe. PCG offers clients a multidisciplinary approach to meet challenges, pursue opportunities, and serve constituents across the public sector. To learn more, visit www.publicconsultinggroup.com .

Summary:

We are seeking a senior-level, detail-oriented and self-motivated Medicaid Waiver Evaluation Consultant to join our team. This role involves analyzing large healthcare datasets and interpreting results of quality measures, supporting strategic initiatives through data-driven insights. This role requires a strong background in data science, healthcare analytics, and a deep understanding of Medicaid waivers.

Duties and Responsibilities

+ Serves as project manager and subject matter expert within the practice including management of a team, and key projects related to waiver evaluation

+ Develops and executes new growth strategies

+ Identifies new sales opportunities and follow-up on sales leads.

+ Analyze large-scale healthcare datasets with minimal supervision to extract actionable insights.

+ Ensure data integrity, reproducibility, and compliance with regulatory and privacy standards

+ ·Utilize SQL, Power BI, and Databricks to calculate and report on standard and customized quality measure sets.

+ Collaborate with cross-functional teams to define specifications for quality measures and key performance indicators (KPIs).

+ Document business processes and analytical methodologies to ensure transparency and repeatability.

+ Develop and implement claims-based quality metrics to assess the performance of Medicaid programs.

+ Analyze large datasets of Medicaid claims to identify trends, patterns, and insights.·Collaborate with healthcare providers, policymakers, and other stakeholders to ensure the relevance and accuracy of quality metrics.

+ Design and conduct statistical analyses to evaluate the impact of policy changes on Medicaid outcomes.

+ Provide technical expertise and support to other team members on data analysis and interpretation.

+ Lead the implementation of major project phases and contribute to project planning and execution.

+ Prepares client deliverables, including written reports, presentations, and status updates.

+ Lead client discussions and present findings and updates to clients in a clear and professional manner.

+ Manages projects, staff, and tasks with limited supervision while meeting and exceeding performance expectations.

+ Participates in sales and business development activities related to the practice, includingleading proposal writing teams, including writing sections, coordinating efforts, and preparing proposalsubmissions.

+ Independently manages complex projects, staff and tasks with limited supervision while meeting and exceeding performance expectations.

Required Skills

+ Experience with healthcare data standards (ICD, CPT, HCPCS, UB-04, 837/835 transactions)

+ Experience with healthcare utilization and quality metrics (NCQA/HEDIS, CMS Core Set)

+ Experience with health plan eligibility and enrollment data

+ Experience programming with R, Python, or other programming languages

+ Experience designing and implementing statistical models to assess the impact of interventions or policy changes, such as interrupted time series and difference-in-difference

+ Familiarity with reporting tools and dashboard design

+ Ability to translate complex regulatory requirements into practical system solutions.

+ Master's in Data Science, Statistics, Public Health, Health Informatics, or a related field.

Qualifications

+ Education: Master’s degreein information science, health economics, public health, health policy, healthcare administration or a related health or quantitative analysis field.

+ Experience: Minimum 5 years of relevant work experience, preferably at CMS institution.

Supervisory Responsibility

+ Business Analyst

+ Consultants

Working Conditions

+ Office Setting

+ Some travel required

The above is intended to describe the general contents and requirements of work being performed by people assigned to this classification. It is not intended to be construed as an exhaustive statement of all duties, responsibilities or skills of personnel so classified.

**PCG does not sponsor newly hired foreign national workers for work authorization, including H-1B sponsorship** .

Compensation:

Compensation for roles at Public Consulting Group varies depending on a wide array of factors including, but not limited to, the specific office location, role, skill set, and level of experience. As required by applicable law, PCG provides a reasonable range of compensation for this role. In addition, PCG provides a range of benefits for this role, including medical and dental care benefits, 401k, PTO, parental leave, bereavement leave.

As required by applicable law, PCG provides the following reasonable range of compensation for this role: $88,300-$108,000. In addition, PCG provides a range of benefits for this role, including medical and dental care benefits, 401k, PTO, parental leave, bereavement leave.

PCG does not sponsor newly hired foreign national workers for work authorization, including H-1B sponsorship.

EEO Statement:

Public Consulting Group is an Equal Opportunity Employer dedicated to celebrating diversity and intentionally creating a culture of inclusion. We believe that we work best when our employees feel empowered and accepted, and that starts by honoring each of our unique life experiences. At PCG, all aspects of employment regarding recruitment, hiring, training, promotion, compensation, benefits, transfers, layoffs, return from layoff, company-sponsored training, education, and social and recreational programs are based on merit, business needs, job requirements, and individual qualifications. We do not discriminate on the basis of race, color, religion or belief, national, social, or ethnic origin, sex, gender identity and/or expression, age, physical, mental, or sensory disability, sexual orientation, marital, civil union, or domestic partnership status, past or present military service, citizenship status, family medical history or genetic information, family or parental status, or any other status protected under federal, state, or local law. PCG will not tolerate discrimination or harassment based on any of these characteristics. PCG believes in health, equality, and prosperity for everyone so we can succeed in changing the ways the public sector, including health, education, technology and human services industries, work.

Public Consulting Group is an equal opportunity employer. All qualified applicants receive consideration for employment without regard to race, color, religion, gender, national origin, age, sexual orientation, gender identity, protected veteran status, or status as a qualified individual with a disability. VEVRAA Federal Contractor.