Job Description & Details
This is a specialized consulting gig focused on keeping a state Medicaid program compliant with complex DSH rules and crunching massive amounts of hospital financial data. If you know your way around CMS guidance, hospital cost reports, and state plan amendments, this role lets you dive straight into high-stakes healthcare policy and payment modeling without the corporate fluff.
What You'll Actually Be Doing
Expect to spend your days knee-deep in hospital financial and utilization data, validating numbers, running complex payment models, and making sure DSH calculations align with federal mandates. You'll act as the bridge between the state agency and healthcare providers, which means translating dense regulatory requirements into clear instructions, resolving data discrepancies, and helping stakeholders navigate audits. It's a mix of rigorous number-crunching and strategic healthcare finance.
The Core Tech Stack
Advanced Microsoft Excel is your bread and butter here—you'll need to build and maintain robust payment models from scratch. Beyond spreadsheets, having familiarity with SQL, Microsoft Access, or dedicated healthcare data analytics tools will make parsing massive datasets infinitely easier. A deep, working knowledge of Medicaid Management Information Systems (MMIS) and hospital reimbursement software is also critical for success.
Interview Expectations
When they interview you, expect them to test your practical understanding of CMS regulations and how you handle edge cases in hospital data reconciliation. They'll likely ask you to walk through a scenario where a hospital's submitted utilization data contains major discrepancies right before a calculation deadline, and they want to see how you troubleshoot it. The hiring manager is secretly looking for someone who doesn't just know the theory of DSH, but has the operational scar tissue to fix broken data pipelines under tight state deadlines.
Application Advice
Your resume needs to immediately scream "Medicaid DSH expert" if you want to clear the ATS filters. Ditch the generic consulting jargon and explicitly highlight your hands-on experience with hospital cost reporting, State Plan Amendments (SPAs), and CMS audit support. Put your advanced Excel and data modeling achievements front and center, using exact terms from the job description like "supplemental payment programs" and "hospital financial data validation" to ensure the recruiter knows you can hit the ground running.