About Sellers Dorsey

The SME Director (working remotely from anywhere in the US) reports to the Managing Director of the Subject Matter Experts team (SME) that is part of our National Medicaid Financing practice, and assists clients and the Sellers Dorsey team by leveraging deep knowledge of policy and/or financial expertise in areas such as Medicaid financing and revenue maximization, provider reimbursement (physician, hospital, other), state and federal Medicaid reimbursement policy, healthcare taxes, intergovernmental transfers, and navigating the shift to value-based payment. They are responsible for policy guidance, development of financial estimates, understanding state and federal reimbursement systems, and oversees junior Medicaid Finance staff, engaging in the full life cycle of employee engagement. 

The SME Director is a key member of the client servicing team, helping implement and manage new programs for clients and ensuring a high level of satisfaction.  In addition to client servicing, the Director assists the sales team by identifying new business opportunities, expanding existing engagements and participating in sales activities, including attending prospective client meetings.

Key Responsibilities/Outcomes:

General Responsibilities and Expectations

• The SME Director is expected to account for hours on a monthly basis. They will be assigned to client project teams and will also spend time on sales and marketing and administrative activities, as needed.  Directors are expected to review periodic activity reports and work with their supervisors to develop strategies to ensure targets are met.
• The SME Director oversees junior Medicaid Finance staff, engaging in the full life cycle of employee engagement.  Example activities include: recruitment, onboarding, mentoring, staffing, employee reviews and coordination with HR throughout an employee’s career.
• The SME Director is expected to travel as needed to meet the needs of client servicing, marketing, and business development. National travel up to 25% may be required.  They understand that work may require periodic availability on weekends and nights.
• The SME Director is responsible for keeping current on the changing federal regulatory environment, learning state specific regulations to support assigned projects, and staying current on industry trends.

Consulting Services

• Depending upon specific areas of expertise, assume significant levels of responsibility on a diverse range of projects and project tasks; develop consulting expertise that can be replicated in future projects.
• Manage all technical aspects of Medicaid financing initiatives.
• Perform assigned and agreed upon project tasks maintaining client satisfaction; takes ownership of work and assists in the development of “client-ready” deliverables.
• Deliver subject matter expertise and consulting services for multiple clients; manage assigned primary research and/or solution development; assist with proposal development, project plan development, data analysis and modeling, presentation development, and delivery of client presentations.
• May serve as a key client contact to respond to questions, provide required communications and be responsible for a successful client engagement.

Business Development

• Use personal industry knowledge, connections, business expertise, public policy awareness and political insight to identify leads that could result in profitable revenue growth for the Firm.
• Actively provide proposal development assistance including proposal drafting, editing, scope development, and related duties and participate in sales meetings, as necessary.
• Actively seek to identify new business opportunities for the Firm within assigned clients to help maximize long term benefits and relationship between the client and Sellers Dorsey.
• In coordination with the marketing team, produce and review content for selected internal and external marketing tools, such as Firm newsletters, conference presentations, website content, and marketing webinars, to highlight the Firm’s capabilities, subject matter expertise and successes.

Knowledge Management

• Leverage policy and/or healthcare solution expertise to help the Firm develop, document and communicate new solutions.

Key Qualifications:

Education and Work Experience

• Bachelor's degree and 15+ or more combined years in Medicaid, provider reimbursement and/or in the healthcare consulting industries.
• Understanding of Medicaid financing and payments.
• Experience working with healthcare data such as claims sets, cost reports, etc.
• Experience with state Medicaid agencies, CMS or healthcare providers preferred.
• Experience with value-based payment arrangements preferred.

Skills

• Extensive practical knowledge and application of Medicaid reimbursement rules.
• Ability to perform all the technical functions of a Medicaid financing initiative including but not limited to:
  • assess potential Medicaid supplemental payments and related transactions in states where the Director may not have prior knowledge.
  • utilize cost reports, disproportionate share (DSH) reports and other large datasets to drive decision points within a project.
  • determine all the steps needed to execute a Medicaid financing initiative.
  • provide detailed data analysis, models and summaries of the financial impact from policy or methodology changes.
  • calculate upper payment limits for a variety of providers and provider classes under the Medicaid program.
  • estimate the potential federal funds generated by an initiative as well as the transaction costs.
  • assess project data needs and collect the data necessary to carry out the above activities.
  • respond to questions and inquiries by the Centers for Medicare and Medicaid Services (CMS) and keep track of recent CMS decisions and decision-making procedures.
  • assist clients in developing policies, procedures and structures required to implement the project.
  • understanding the connection between reimbursement and quality/value at both the state and provider levels.
  • provide subject matter expertise related to Medicaid managed care, rate development, and metrics related to clinical or financial measurement.
  • serve as a manager and mentor to junior staff, leveraging as appropriate to execute client deliverables.
• High proficiency in Microsoft Word, Excel required and database experience (e.g. SQL) for large datasets preferred.
• Simultaneously balance the needs and timeliness of many projects.
• Work closely with the project director and project managers to draft public notices, state plan amendments, 438.6(c) preprints, waiver amendments, memos, workplans, and external or internal progress reports, client-ready spreadsheets and calculations.
• Provide technical leadership and explanation to multiple levels of the organization to build internal capacity and foster knowledge management.
• Excellent oral and written communication skills including relaying complex technical terms in an easy to understand manner. This includes producing written or pictorial materials for external and internal use and to present calculations in a manner that the client or other staff can reasonably follow.
• Ability to interact professionally with clients and other outside audiences.
• Work with legal counsel when necessary in designing new payment initiatives and assess and mitigate risk as appropriate.

Core Behaviors and Competencies:

• Build positive relationships within and outside the Firm.
• Take ownership for one’s professional development by increasing knowledge, skills and abilities in areas that are critical to the Firm’s success.
• Collaborate and share knowledge with other Firm staff.
• Demonstrate formal and ad hoc team leadership in projects, issues or organizations that are critical to achieving the Firm’s strategic goals.
• Be self-motivated, and be an advocate for one’s abilities and talents, both internally and externally.