We specialize in assisting government-sponsored programs in becoming more efficient purchasers of health services. We bring the best critical thinkers forward in helping our clients address their issues
The Medicaid Nursing Facility Rate Methodology Specialist partners with state governments to design and develop nursing facility methodologies and rates, working closely with clients, team members and external stakeholders.
This role provides you with an opportunity to work in a team environment to ensure client recommendations contain multiple points of view
Beyond the in-depth training provided, new employees are included on client teams immediately, providing unique opportunities to learn more while helping team members with critical workloads and making a difference to our clients
As part of Mercer, the Government Human Services Consulting (GHSC) team offers its expertise within a small business atmosphere
What's in it for you?
Mercer's Health business has the world's largest and most influential benefits brokerage and consulting capabilities
Work with the team that provides the optimal combination of local-market knowledge and nationally-driven best practices
We run many social and new-hire events, outings, and employee networks. Having fun in the work you do comes from being a part of a client team and contributing to its success
We will count on you to:
Be a client-facing consultant with expertise in Medicaid facility reimbursement design and rate setting and implementation, with a focus on nursing facility reimbursement.
Provide strategic support to State clients when establishing facility reimbursement rates, keeping a pulse on Medicaid provider reimbursement for other states and payers, including Medicare.
Guide clients in all areas of a reimbursement methodology design, such as: rate setting design and development, Medicaid/Medicare cost report collection, stakeholder partnering, State implementation and operations and establishment of strategic plans/goals, data validation and analysis, and regulation implementation.
Present recommendations to clients to ensure successful implementation of facility reimbursement rates.
Establish tools to identify important data elements that should be captured and evaluated. Including guidance on common issues and best practices regarding facility cost reports.
Establish and mentor team of staff to support Medicaid provider reimbursement projects. Recommend appropriate training to prepare teams for existing and future work.
What you need to have:
Bachelor's degree (required)
5+ years of experience as leader of Medicaid nursing facility or hospital provider reimbursement for a state or federal government agency, nationally recognized organization, or consulting firm, etc. (can be congruent with the following);
7+ years of Medicaid experience - either through program administration, consulting support and/or research.
Experience with industry-standard and emerging best practices in innovations and interventions regarding provider reimbursement
Experience with rate development components such as methodology design, provider cost variations and consideration for regulations.
Experience engaging stakeholders of federal, state, or local government agencies, and provider communities.
Experience with Medicaid claims data preferred, with particular concentration on Medicaid claims and encounters, including Managed Care delivery models.
Experience with federal and Medicare reporting associated with hospitals or Nursing Facilities preferred (Medicare Nursing Facility Cost Reports, MDS data, CMS-published nursing facility reports and data, Medicare Hospital Cost Reports, etc.)
What makes you stand out:
Some level of nursing home or hospital administration experience.
Familiarity with Medicaid Managed Care quality incentive programs and/or VBP.
Mercer believes in building brighter futures by redefining the world of work, reshaping retirement and investment outcomes, and unlocking real health and well-being. Mercer's approximately 25,000 employees are based in 43 countries and the firm operates in 130 countries. Mercer is a business of Marsh McLennan (NYSE: MMC), the world's leading professional services firm in the areas of risk, strategy and people, with more than 85,000 colleagues and annual revenue of over $20 billion. Through its market-leading businesses including Marsh, Guy Carpenter and Oliver Wyman, Marsh McLennan helps clients navigate an increasingly dynamic and complex environment. For more information, visit mercer.com. Follow Mercer on LinkedIn and X.
Marsh McLennan 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 TANA@mmc.com
Marsh McLennan 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 McLennan 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 $115,200 to $230,400.
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.
