Medicaid Claims Specialist (Consultancy)

Please submit Cover Letter and CV to Cowan at

The main objective of the HRSA 21-083 project is to enhance U.S. states’ capacity to improve viral load data collection, quality assurance, and reporting to their local Medicaid agencies. This is to help them conduct enhanced reporting of aggregate HIV viral load measure as part of the Centers for Medicare and Medicaid Services (CMS) Adult Core Set. Working with the National Alliance of State and Territorial AIDS Directors (NASTAD) and other partners, CGHPI is working to integrate data between departments and organizations in this project.

The Medicaid Claims Specialist will assist the project by providing expertise surrounding data flows and processes within Medicaid.

Primary Responsibilities:

  • Participate in internal and external meetings to discuss Medicaid’s current processes and continued participation throughout the HRSA 21-083 project.
  • Help coordinate data sharing and collection with knowledge of Medicaid claims data
  • Facilitate communications between state Medicaid offices and state health departments to help states provide accurate HIV viral load measures to CMS.
  • Understand complex challenges regarding Medicaid claims data and HIV surveillance reporting measures and work with states to reconcile these issues
  • Participate in internal and external meetings
  • Perform other duties as needed within the scope of the project
  • Part-time, 20 hours/week

Skills and Qualifications:

  • Understanding of Medicaid HIV data flows, surveillance, and care services
  • Ability to work with multiple states’ Medicaid offices
  • Familiarity with multi-organization projects and interdisciplinary teams
  • Strong analytical and communications skills
  • Experience with large data sets
  • Knowledge of analyzing data with SAS or R