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Huxley Reynolds
Medicaid Analyst
Summary
Highly experienced Medicaid Analyst with a proven track record of success in analyzing Medicaid claims data, developing cost-saving strategies, and ensuring compliance with Medicaid regulations. Collaborated with state and federal agencies to improve the efficiency and effectiveness of the Medicaid program. Demonstrated expertise in Medicaid policy, program management, eligibility determination, reimbursement analysis, fraud and abuse investigation, and managed care contracting.
Education
Master’s Degree in Public Health
July 2019
Skills
- Medicaid Policy Analysis
- Medicaid Program Management
- Medicaid Eligibility Determination
- Medicaid Reimbursement Analysis
- Medicaid Fraud and Abuse Investigation
- Medicaid Managed Care Contracting
Work Experience
Medicaid Analyst
- Conducted audits to identify and recover improper Medicaid payments
- Provided technical assistance to Medicaid providers on billing and coding issues
- Developed and presented training materials on Medicaid policies and procedures
- Managed a team of analysts responsible for Medicaid data analysis
Medicaid Analyst
- Analyzed Medicaid claims data to identify trends and patterns in utilization and expenditures
- Developed and implemented strategies to reduce Medicaid costs while maintaining quality of care
- Negotiated with managed care organizations to secure favorable rates for Medicaid beneficiaries
- Collaborated with state and federal agencies to ensure compliance with Medicaid regulations
Accomplishments
- Developed and implemented a data analytics model that improved Medicaid fraud detection by 20%, saving the state $5 million annually.
- Led the Medicaid eligibility verification process improvement project, reducing processing time by 30% and improving accuracy by 5%.
- Established a stakeholder engagement program that fostered collaboration with key Medicaid stakeholders, ensuring effective policy development and implementation.
- Collaborated with state agencies to develop and implement a Medicaid data sharing system that enhanced program integrity and promoted crossagency coordination.
- Conducted a comprehensive Medicaid program review that identified areas for cost savings and operational efficiency improvements.
Awards
- Received the Medicaid Analyst of the Year Award for exceptional performance in Medicaid program analysis and administration.
- Honored with the Excellence in Medicaid Policy Analysis Award for contributions to the development and implementation of innovative Medicaid policies.
- Recognized with the Healthcare Policy Leadership Award for developing a comprehensive Medicaid managed care program that expanded access to quality healthcare for underserved populations.
- Received the Medicaid Quality Improvement Award for developing and implementing a datadriven approach to improve Medicaid program outcomes.
Certificates
- Certified Medicaid Analyst (CMA)
- Certified Medicaid Compliance Professional (CMCP)
- Certified Medicaid Manager (CMM)
- Certified Medicaid Finance Manager (CMFM)
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How To Write Resume For Medicaid Analyst
- Quantify your accomplishments by providing specific metrics and results.
- Highlight your expertise in Medicaid policy and program management.
- Demonstrate your ability to work independently and as part of a team.
- Showcase your strong communication and interpersonal skills.
- Proofread your resume carefully for any errors.
Essential Experience Highlights for a Strong Medicaid Analyst Resume
- Analyze Medicaid claims data to identify trends, patterns, and outliers in utilization and expenditures.
- Develop and implement strategies to reduce Medicaid costs while maintaining quality of care.
- Negotiate with managed care organizations to secure favorable rates for Medicaid beneficiaries.
- Collaborate with state and federal agencies to ensure compliance with Medicaid regulations.
- Conduct audits to identify and recover improper Medicaid payments.
- Provide technical assistance to Medicaid providers on billing and coding issues.
- Develop and present training materials on Medicaid policies and procedures.
- Manage a team of analysts responsible for Medicaid data analysis.
Frequently Asked Questions (FAQ’s) For Medicaid Analyst
What is the role of a Medicaid Analyst?
A Medicaid Analyst is responsible for analyzing Medicaid claims data to identify trends and patterns in utilization and expenditures. They develop and implement strategies to reduce Medicaid costs while maintaining quality of care. Medicaid Analysts also collaborate with state and federal agencies to ensure compliance with Medicaid regulations.
What are the qualifications for a Medicaid Analyst?
A Medicaid Analyst typically needs a bachelor’s or master’s degree in public health, health policy, or a related field. They also need to have experience in Medicaid policy and program management. Strong analytical and communication skills are also essential.
What are the key skills for a Medicaid Analyst?
The key skills for a Medicaid Analyst include Medicaid policy analysis, Medicaid program management, Medicaid eligibility determination, Medicaid reimbursement analysis, Medicaid fraud and abuse investigation, and Medicaid managed care contracting.
What is the job outlook for Medicaid Analysts?
The job outlook for Medicaid Analysts is expected to be good over the next decade. The aging population and the increasing number of people with chronic conditions are expected to lead to increased demand for Medicaid services. This will, in turn, lead to increased demand for Medicaid Analysts.
What is the salary range for Medicaid Analysts?
The salary range for Medicaid Analysts varies depending on experience, education, and location. However, the median annual salary for Medicaid Analysts is around $65,000.
What are the benefits of working as a Medicaid Analyst?
The benefits of working as a Medicaid Analyst include a competitive salary, a good benefits package, and the opportunity to make a difference in the lives of others. Medicaid Analysts play a vital role in ensuring that Medicaid beneficiaries have access to the care they need.