Medicare Part C Consultant

Job Summary

A company is looking for a Part-Time/Project-Based Senior Consultant in Health Plan Services (Part C).

Key Responsibilities

• Provide subject matter expertise on operational and compliance areas of Medicare Part C
• Review, interpret, and implement state and federal guidance related to Medicare operations
• Support multiple client engagements, ensuring operational compliance with CMS standards

Required Qualifications

• Bachelor's degree, RN with a minimum of ten years in government, health care, or quality profession
• Experience with Medicare and/or Medicaid requirements and CMS audits
• Strong Microsoft Office Suite skills, particularly in Word, Excel, and PowerPoint
• Experience developing and managing quality programs, including NCQA accreditation and HEDIS
• Expert understanding of medical management and utilization management processes