BerryDunn is seeking a Third-Party Liability (TPL) Subject Matter Expert (SME) to join our Medicaid Practice Group. This position will support client work for a State Health and Human Services (HHS) agency that has requested subject matter expertise and technical support services to strengthen and enhance its TPL program. The TPL SME will focus on ensuring Medicaid operates as the payer of last resort by supporting identification, coordination, and recovery of payments from liable third parties such as commercial insurers, Medicare, and casualty/liability carriers.

In this role, the TPL SME will review existing TPL processes, support business process redesign (BPR) efforts, and provide guidance to agency staff on compliance with federal and state requirements. The position will also provide support for audits, federal reporting, and quality assurance activities related to TPL recovery. In addition, the TPL SME will be responsible for assisting the agency in policy interpretation, training development, and data analysis to maximize recoveries and strengthen operational efficiency.

Your initial focus will be on supporting our Hawai'i client. You will report to and partner with senior management in our Medicaid team, both for client work and career development. With a growth mindset, you will drive your development with the support of a learning and development culture.

This position offers flexibility in work location, with the option to work fully onsite or in a hybrid capacity. Given that you may be collaborating with teams across multiple time zones, you will need to manage your schedule effectively to ensure availability for meetings and meet deadlines, while having the freedom to work independently when necessary.

Travel Expectations: Travel to client sites can range up to 50%.

• Provide frequent, clear, and consistent communication to the client, team members, vendors, and stakeholders regarding TPL activities and outcomes.
• Participate in TPL unit and/or cross-functional Medicaid team meetings to provide SME input and updates.
• Perform quality reviews of claims, eligibility records, and third-party data to ensure Medicaid is acting as the payer of last resort.
• Review existing TPL processes and support business process redesign (BPR) efforts to increase efficiency, compliance, and recovery outcomes.
• Serve as an SME on TPL policies, regulations, and recovery processes, guiding staff and State leadership.
• Aid in the development of policies, procedures, and training materials to strengthen TPL operations.
• Support audits, federal reporting, and compliance reviews related to TPL performance and recovery.
• Perform assigned administrative and technical tasks efficiently and effectively, asking questions when instructions are unclear.

• Ability to conduct research and analysis related to Medicaid claims, eligibility systems, and third-party payer data to identify recovery opportunities.
• Strong knowledge of federal and state TPL requirements and coordination of benefits processes.
• Prior experience supporting a state Medicaid agency TPL program (preferred experience in cost avoidance, recovery, or related audit/compliance activities).
• Experience reviewing processes and supporting business process redesign (BPR) efforts.
• Strong experience with Microsoft Excel, Word, and PowerPoint, and ability to work with Medicaid eligibility and claims processing systems.
• Demonstrated ability to interpret and apply complex regulations, policies, and contracts related to Medicaid and TPL.
• Excellent written and verbal communication skills, with the ability to convey technical TPL concepts clearly to staff, leadership, and external partners.

The base salary range targeted for this role is $85,000 - $115,000. This salary range represents BerryDunn’s good faith and reasonable estimate of the range of possible compensation at the time of posting. If an applicant possesses experience, education, or other qualifications more than the minimum requirements for this posting, that applicant is encouraged to apply, and a final salary range may then be based on those additional qualifications; compensation decisions are dependent on the facts and circumstances of each case. The salary of the finalist selected for this role will be based on a variety of factors, including but not limited to, years of experience, depth of experience, seniority, merit, education, training, amount of travel, and other relevant business considerations.

Our people are what make BerryDunn special, and in return we strive to support our employees and help them thrive. Eligible employees have access to benefits that go beyond what’s expected to support their physical, mental, career, social, and financial well-being. Visit our website for a complete list of benefits and a look into our culture: Experience BerryDunn.

We will ensure that individuals are provided reasonable accommodation to participate in the job application or interview process or perform essential job functions. Please contact careers@berrydunn.com to request an accommodation.

We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace.

About BerryDunn

BerryDunn is the brand name under which Berry, Dunn, McNeil & Parker, LLC and BDMP Assurance, LLP, independently owned entities, provide services. Since 1974, BerryDunn has helped businesses, nonprofits, and government agencies throughout the US and its territories solve their greatest challenges. The firm’s tax, advisory, and consulting services are provided by Berry, Dunn, McNeil & Parker, LLC, and its attest services are provided by BDMP Assurance, LLP, a licensed CPA firm. 

BerryDunn is a client-centered, people-first professional services firm with a mission to empower the meaningful growth of our people, clients, and communities. Led by CEO Sarah Belliveau, the firm has been recognized for its efforts in creating a diverse and inclusive workplace culture, and for its focus on learning, development, and well-being. Learn more at berrydunn.com.

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