Medicaid DSH Payment Analysis Specialist
TeleSolv Consulting
$95,000 - $105,000 / year
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Description
Key Responsibilities
- Assess recent court decisions and federal policy changes or clarifications for their potential effect on the Government’s Medicaid program.
- Assess the appropriateness of State Plan resubmissions when necessary.
- Evaluate the current administration of DSH supplemental payments and recommend potential improvements.
- Support DSH program audits.
- Identify and collect the information and documentation required from qualified and eligible providers.
- Gather applicable data from eligible hospitals, the Government and other relevant sources.
- Review submitted data for reasonableness and accuracy.
- Work with hospitals and Government stakeholders to resolve data discrepancies.
- Calculate DSH rates and supplemental payments.
- Develop a draft DSH payment schedule for the upcoming state fiscal year.
- Calculate the DSH payment model for the year under review.
- Review and discuss draft payment-model results with Government stakeholders.
- Modify payment-model calculations when requested by the Government.
- Deliver final payment-model calculations in the format specified by the Government.
- Draft proposed communications to eligible hospitals concerning methodology, data collection and submission deadlines.
- Obtain Government approval before conducting outreach to participating hospitals.
- Develop and deliver education on DSH requirements, data sources, survey tools and documentation practices.
- Maintain project quality through proven standards and methodologies.
- Complete assigned work on schedule.
Skills, Knowledge and Expertise
- Knowledge of Medicaid data and healthcare payment information.
- Detailed understanding of DSH rules, regulations and related issues.
- Detailed understanding of Medicaid rules, regulations and related issues.
- Ability to interpret federal policy changes and relevant court decisions.
- Ability to collect, reconcile and validate data from multiple sources.
- Ability to identify and resolve discrepancies in hospital and Government data.
- Experience calculating payment rates, payment models and schedules.
- Ability to prepare clear communications for participating hospitals.
- Ability to explain technical DSH requirements, data sources and survey tools to stakeholders.
- Strong quality-control, documentation and time-management capabilities.
- Ability to work independently in a remote environment and travel on-site when required.
Benefits
- Experience working with Medicaid data.
- At least three years of experience working with DSH rules, regulations and related issues.
- At least three years of experience working with Medicaid rules, regulations and related issues.
- Ability to perform remote work within the continental United States.
- Ability to work on-site in Pierre, South Dakota, for a limited portion of the engagement when required.
Benefits
- Experience working with Medicaid data. At least three years of experience working with DSH rules, regulations and related issues. At least three years of experience working with Medicaid rules, regulations and related issues. Ability to perform remote work within the continental United States. Ability to work on-site in Pierre, South Dakota, for a limited portion of the engagement when required.
About this role
TeleSolv Consulting is looking for someone to manage the technical and analytical side of a state's Medicaid DSH supplemental payment program. You'd assess how policy changes and court decisions affect the program, evaluate whether the state's administration is sound, collect and validate hospital data, calculate payment rates and schedules, and support program audits. The work involves regular coordination with hospitals and government stakeholders to resolve data issues and explain methodology, along with developing communications and training materials on DSH requirements.
This role demands deep expertise in both Medicaid and DSH regulations, plus strong analytical skills—you'll be reconciling data from multiple sources, identifying discrepancies, and building payment models independently. You need at least three years of hands-on experience with both DSH and Medicaid rules, comfort interpreting federal policy and regulatory changes, and the ability to communicate technical requirements clearly to non-technical audiences. The position is based in Pierre, South Dakota and requires in-office work, though some remote work within the continental US may be possible during parts of the engagement.
The salary range is $95,000–$105,000 annually. This is a full-time role suited to someone with a solid track record in healthcare payment analysis who wants to focus on a specific, complex program rather than a broad portfolio.
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Pay for this role
$95,000 to $105,000 per year
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