Senior Medicaid DSH Consultant

Medicaid DSH Consultant (DSH stands for Medicaid Disproportionate Share Hospital which is a federal/state funding program that provides additional payments to hospitals that serve large number of Medicaid patients and uninsured individuals) ONLY candidates who supported State clients dealing with health would have this Client: State of South Dakota (it'll be with the dept of health since they mention medicaid) Make sure skills on job are on resume for the years required.

Salary: $80-90/hr

Send resume, (make sure everything is mentioned), DL and if they have a visa. Video interview multi-year duration. Most visas work (just NO OPT/CPT and h1b).

Position Summary

We are seeking an experienced Senior Medicaid DSH Consultant to support the State Medicaid program in the analysis, administration, and calculation of Disproportionate Share Hospital (DSH) supplemental payments. The consultant will provide subject matter expertise related to Medicaid reimbursement methodologies, federal and state regulatory compliance, DSH payment calculations, hospital data analysis, audit support, and program improvement initiatives. The consultant will work closely with healthcare providers and Medicaid stakeholders to ensure accurate and timely calculation of DSH payments and compliance with applicable regulations.

Key Responsibilities

• Analyze and assess federal policy changes, CMS guidance, and court decisions impacting Medicaid DSH programs.
• Evaluate DSH payment methodologies and recommend program improvements.
• Support State Medicaid Plan reviews, updates, and resubmissions when required.
• Collect and validate hospital financial, utilization, and Medicaid-related data required for DSH calculations.
• Calculate DSH payment amounts and develop annual DSH payment models and schedules.
• Perform detailed healthcare reimbursement and payment analysis.
• Assist with DSH audits and compliance reviews.
• Identify and resolve data discrepancies with hospitals and Medicaid program staff.
• Develop provider education materials, training sessions, surveys, and communication plans.
• Communicate DSH methodology, data requirements, and submission deadlines to participating hospitals.
• Prepare reports, documentation, and final payment calculation deliverables.
• Ensure project deliverables are completed accurately and within established timelines.

Must-Have Skills & Experience Required

Experience

• Minimum 3 years of experience working with Disproportionate Share Hospital (DSH) programs, rules, regulations, and related issues.
• Minimum 3 years of experience working with Medicaid rules, regulations, and policy requirements.
• Experience working with Medicaid data analysis and reporting.
• Experience calculating healthcare reimbursement or supplemental payment programs.
• Experience validating, reconciling, and analyzing hospital financial and utilization data.

Required Technical Skills

• Medicaid reimbursement methodologies
• DSH payment calculations
• Healthcare financial analysis
• Payment modeling and forecasting
• Data validation and reconciliation
• Audit support and compliance reviews
• Regulatory interpretation
• Hospital survey and data collection processes
• Advanced Microsoft Excel
• Reporting and documentation development

Required Domain Knowledge

• Medicaid programs
• DSH regulations and requirements
• State Medicaid Plans
• Hospital reimbursement methodologies
• CMS regulations and guidance
• Healthcare finance and supplemental payment programs

Preferred Skills & Qualifications

Preferred Education

• Bachelor's or Master's degree in:
• Healthcare Administration
• Public Health
• Healthcare Finance
• Finance
• Economics
• Accounting
• Health Policy
• Business Administration

Preferred Experience

• Experience supporting State Medicaid agencies.
• Experience with Medicaid supplemental payment programs.
• Experience with healthcare consulting firms.
• Experience with CMS audits and compliance initiatives.
• Experience preparing State Plan Amendments (SPA).
• Hospital cost reporting experience.
• Managed Care and Fee-for-Service Medicaid experience.

Preferred Tools

• Advanced Excel modeling
• Access, SQL, or healthcare data analytics tools
• Medicaid Management Information Systems (MMIS)
• Healthcare reimbursement software

Ideal Candidate Profile

The strongest candidate will likely come from organizations such as:

• Myers & Stauffer
• Milliman
• Mercer
• Public Consulting Group (PCG)
• Gainwell Technologies
• Medicaid consulting firms
• State Medicaid agencies
• Hospital reimbursement consulting organizations