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Consulting
Fully Remote
Full time
Atlanta Georgia United States
Consulting
On Demand Talent
About This RoleProject manager responsible for Medicaid financial improvement and revenue-cycle workstreams so benefits, charge capture, claims processing, and encounter reporting are configured accurately against applicable Medicaid fee schedules and covered services. Close gaps where payment policies do not exist and financial integrity is at risk.
W2 Hourly Rate: $70-80/hr DOE
Expected Duration: 6+ months
What You Will Work On- Manage configuration of Medicaid benefits, charge capture rules, claims edits, and encounter reporting to match state fee schedule and covered services.
- Identify and remediate financial-integrity issues (incorrect payments, missed charge capture, incomplete or rejected encounters).
- Develop or tighten payment policies as needed
- Understanding of end-to-end revenue-cycle work: requirements, configuration, testing/UAT, claims and encounter validation, issue resolution, and go-live support.
- Coordinate health-plan operations, finance, claims, IT/config, compliance, and state-reporting stakeholders.
- Maintain issue logs, decision logs, and a clear path from current-state gaps to an accurate, auditable Medicaid payment and encounter process.
What You Will Bring- Medicaid revenue cycle: benefits configuration, charge capture, claims processing, and encounter reporting.
- State Medicaid fee schedules and covered-services mapping (Maryland Medicaid strongly preferred; similar state Medicaid acceptable).
- Payment policy design and financial / program integrity (overpayment, underpayment, encounter completeness).
- Project management of cross-functional ops + finance + IT work in a health plan or integrated delivery system
- Ability to operate when source-of-truth payment policies are missing or incomplete-document, decide, configure, and implement.
What You Can Expect- An inspirational place for you to do your best work, be engaged in meaningful ways, and continually develop the skills, competencies and qualities that set our team apart.
- Compensation commensurate with your qualifications, experience, and other factors including geographic location, market and operational factors.
- Total Rewards include: Medical, Dental, Vision, Life Insurance, Disability Insurance, 401(k) Savings Plan, Employee Stock Purchase Plan, Professional Development Program, Paid Time Off and Paid Sick Time (in geographies where legally required).
