Senior Government Consultant I – Program Integrity Specialist (Medicaid)

Location: Phoenix, Arizona; Minneapolis, Minnesota; Washington, District of Columbia; or Atlanta, Georgia, United States. Hybrid work requires at least three days per week in a local hirify.global office or onsite with clients; remote requests are reviewed case by case.

Base salary: $88,000–$176,000 per year, plus potential performance-based incentives.

Company

hirify.global provides risk, reinsurance, capital, people and investments, and management consulting services globally.

What you will do

• Lead complex consulting projects and project teams for state Medicaid, CHIP, and related state agencies.
• Develop client deliverables, presentations, documentation, tools, and reusable intellectual capital.
• Support fraud, waste, and abuse prevention, compliance monitoring, risk assessment, claims review, and external audit coordination.
• Interpret Medicaid policy, federal and state requirements, and applicable Code of Federal Regulations to advise clients on program and reporting changes.
• Coordinate priorities, stakeholders, subcontractors, vendors, budgets, timelines, deliverable quality, and client communications.
• Mentor team members, manage team dynamics, identify staffing needs, and support business development.

Requirements

• High school diploma, bachelor's degree, five years of experience, or a combination of education and experience.
• Knowledge of Medicaid program integrity, fraud, waste, and abuse prevention, provider oversight, claims review, audit support, compliance monitoring, or related public-sector healthcare operations.
• Strong critical-thinking, analytical problem-solving, interpersonal, written, oral communication, presentation, organization, attention-to-detail, and time-management skills.
• Ability to manage, motivate, and mentor early-career staff.
• Ability to prioritize and pivot among multiple tasks while supporting or leading large, complex projects and managing multiple deadlines.
• Comfort working in a fast-paced environment.

Nice to have

• Experience with a state Medicaid agency or Medicaid managed-care entity in program integrity, audit, quality assurance, compliance, or claims operations, including MFCU or SIU experience.
• Certification such as CPC, CFE, CPMA, CIA, AHFI, or an equivalent credential.
• Project management or project leadership credentials.
• Previous Medicaid consulting experience.

Culture & Benefits

• Professional development opportunities, meaningful work, and supportive leaders.
• Inclusive and flexible work environment with collaboration across colleagues, clients, and communities.
• Health and welfare benefits, tuition assistance, 401(k) savings and retirement programs, and employee assistance programs.
• Hybrid work combines remote flexibility with office collaboration and professional development; colleagues are expected to work in their local office or onsite with clients at least three days per week.