Business Operations Analyst I

OverviewPublic Consulting Group LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, technology, and human services agencies to improve lives. Founded in 1986 and headquartered in Boston, Massachusetts, PCG employs approximately 2,000 professionals worldwideall committed to delivering solutions that change lives for the better. The firm has extensive experience in all 50 states, Canada, and a growing practice in Europe. PCG offers clients a multidisciplinary approach to meet challenges, pursue opportunities, and serve constituents across the public sector. To learn more, visit . Responsibilities* Candidate''s residential location must be as follows: Role is remote but candidate must live in the Pacific or Mountain time zone (required) Washington, Utah, or Idaho preferred. Monitor and manage monthly and quarterly Medicaid eligibility processes, including tracking eligibility trends and preparing files for system importConduct a monthly quality assurance process for 40+ clients, including monitoring claiming trends and completing quality checks on a sampling of claims being submitted for reimbursement. Continual focus on compliance and reimbursement optimizationManage ad hoc client requests, including but not limited to investigating client-facing claiming inquiries and preparing claiming resubmission requestsServe as the main point of contact for internal claiming inquiries and collaborate across teamsContact the state Medicaid agency support center as appropriate/neededPrepare regular and ad hoc client reports and assist with the creation of client-facing agendas/materialsGain a detailed understanding of Medicaid and claiming processes and the appropriate application of policy to processesPrepare for, and participate in, meetings focused on claiming operations and optimizationLearn and become proficient with PCG systems, including overall management, updates, and integration/interactionRequired Skills: Ability to evaluate, prioritize, and perform operational and analytical tasksAbility to build and maintain working relationships with internal and external contactsStrong Microsoft application skills including Word, Excel, and PowerPointPrior experience with a task management system a plus (e.g., Asana or Jira)Excellent organizational and communication skillsAbility to work both in a team environment and autonomouslyExisting knowledge or experience with state government, health insurance payment systems (particularly Medicaid), and/or cost accounting are highly advantageous.QualificationsEducation: Bachelors degree preferred or 2+ relevant years experience required.Experience: 2+ years of experience in operations and/or data analysis preferred.LI-RemoteLI-DL1EEO StatementPublic 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.>Job Locations USPosted Date 2 months ago (6/30/2022 4:58 PM)Job ID 2022-8281 of Openings 1Category Customer Service/SupportType Regular Full-TimePractice Area Education ServicesPublic 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.

Created: 2025-09-06