Senior Government Consultant I - Program Integrity Specialist

Company:Mercer

Description:

We are seeking a talented individual to join our Government Health Consulting (GHC) team at Marsh. This can be based anywhere near a Marsh office and offers a hybrid work arrangement, requiring a minimum of three days per week in the office. Remote working requests will be handled on a case-by-case basis. 

As a Senior Government Consultant I – Program Integrity Specialist, you will play a vital role as a core team member providing expert insights on complex projects for clients, which are primarily state Medicaid and Children’s Health Insurance Program (CHIP) agencies and related state agencies responsible for Medicaid and CHIP fee-for-service and managed care programs. This is a great opportunity to join a global company known for its dynamic culture, excellent benefits, and commitment to professional growth where you can experience meaningful work alongside supportive leaders dedicated to your success!  

 

Senior Government Consultant I – PI Specialist

We will count on you to: 

• Provide project leadership, thought leadership, project team leadership, and targeted business development
• Lead and contribute to client deliverables, presentations, and project documentation with increasing ownership over time
• Collaborate with cross-functional teams to understand how regulatory requirements translate into changes to programs, services, and quality reporting
• Participate in and lead client projects related to fraud, waste, and abuse prevention; compliance monitoring; risk assessment; and external audit coordination;
• Coordinate project priorities, client needs, subcontractor/vendor collaboration, deliverable development, workgroup activity, and leadership reporting   
• Coordinate and manage project teams, ensuring the team is within budget, on time, and producing work consistent with the scope of work; and ensuring communication with the client, project team, and client manager
• Work with Division and Sector leadership to identify and secure staffing resources, ensuring work is leveraged to the right skill and career level, and providing team members with opportunities to develop their skills and expertise
• Interpret and apply Medicaid policy, federal and state requirements, and applicable Code of Federal Regulations; consider the implication of new trends or changes in policies or regulations on clients’ programs; and bring a forward-looking/strategic perspective to counsel the internal client team and clients
• Engage and collaborate with stakeholders, including Medicaid leadership, managed care entities, providers, and beneficiaries, to gather feedback and inform program recommendations 
• Manage the quality and timeliness of client deliverables, communicating regularly and effectively with project teams
• Develop intellectual capital; lead or participate in the development of tools or processes that can be leveraged for multiple clients
• Be responsible for motivating and encouraging team members. Manage project team dynamics and nurture collaboration amongst team members, including subcontractors/vendors

What you need to have:   

• High school diploma, Bachelor's degree (BA/BS), 5 years of experience, or a combination of education and experience
• Knowledge of Medicaid program integrity, fraud, waste, and abuse prevention, provider oversight, claims review, audit support, compliance monitoring, or related public sector healthcare operation
• Strong critical thinking and analytical problem-solving skills
• Excellent interpersonal skills
• Ability to manage, motivate, and mentor early career staff
• Strong written and oral communication skills, as well as presenting information to clients/groups
• Ability to prioritize, handle, and pivot among multiple tasks in a demanding work environment with a proven track record in supporting or leading large, complex projects
• Comfort working in a fast-paced environment and managing multiple project deadlines
• Excellent attention to detail, organization, and time management skills 

What makes you stand out?  

• Experience working for a State Medicaid agency or Medicaid managed care entity, supporting program integrity, audit, quality assurance, compliance, or claims operations (e.g., MFCU, SIU)
• Professional certification as a Certified Professional Coder (CPC), Certified Fraud Examiner (CFE), Certified Professional Medical Auditor (CPMA), Certified Internal Auditor (CIA), Accredited Healthcare Fraud Investigator (AHFI), or equivalent
• Project management and/or project leadership credentials
• Previous Medicaid consulting experience

Why join our team: 

• We help you be your best through professional development opportunities, interesting work, and supportive leaders.  
• We foster a vibrant and inclusive culture where you can work with talented colleagues to create new solutions and have an impact on colleagues, clients, and communities. 

Our scale enables us to provide a range of career opportunities, as well as benefits and rewards to enhance your well-being.  

Marsh (NYSE: MRSH) is a global leader in risk, reinsurance and capital, people and investments, and management consulting, advising clients in 130 countries. With annual revenue of over $27 billion and more than 95,000 colleagues, Marsh helps build the confidence to thrive through the power of perspective. For more information, visit marsh.com, or follow us on LinkedIn and X.

Marsh is committed to embracing a diverse, inclusive and flexible work environment. We aim to attract and retain the best people and embrace diversity of age background, disability, ethnic origin, family duties, gender orientation or expression, marital status, nationality, parental status, personal or social status, political affiliation, race, religion and beliefs, sex/gender, sexual orientation or expression, skin color, veteran status (including protected veterans), or any other characteristic protected by applicable law. If you have a need that requires accommodation, please let us know by contacting [email protected].

Marsh is committed to hybrid work, which includes the flexibility of working remotely and the collaboration, connections and professional development benefits of working together in the office. All Marsh colleagues are expected to be in their local office or working onsite with clients at least three days per week. Office-based teams will identify at least one “anchor day” per week on which their full team will be together in person.

The applicable base salary range for this role is $88,000 to $176,000.

The base pay offered will be determined on factors such as experience, skills, training, location, certifications, education, and any applicable minimum wage requirements. Decisions will be determined on a case-by-case basis. In addition to the base salary, this position may be eligible for performance-based incentives.

We are excited to offer a competitive total rewards package which includes health and welfare benefits, tuition assistance, 401K savings and other retirement programs as well as employee assistance programs.