Remote Principal Consultant – Medicaid Claims & Compliance Lead for Life Sciences (Strategic Business Services)

About Workwarp and Our Mission

At Workwarp, we are at the forefront of delivering innovative, data‑driven solutions to the life‑sciences industry. Our Business Services division partners with pharmaceutical companies, biotechnology innovators, and healthcare providers to navigate the ever‑changing landscape of government‑mandated programs, especially Medicaid. By blending deep regulatory expertise with cutting‑edge technology, we help our clients accelerate product delivery, protect revenue streams, and stay compliant with a complex web of federal and state requirements.

Our remote‑first culture empowers top talent from around the globe to collaborate, innovate, and drive impact without the constraints of a traditional office environment. We invest heavily in continuous learning, professional growth, and a supportive community that values curiosity, integrity, and excellence.

Role Overview – Principal Consultant, Medicaid

We are seeking an experienced, strategic, and detail‑oriented Medicaid expert to join our Business Services team as a Principal Consultant – Medicaid Claims & Compliance Lead. This senior‑level position will serve as a trusted advisor to our life‑science clients, ensuring flawless Medicaid claims processing, strategic alignment with client priorities, and rigorous adherence to government contracting compliance. The role is fully remote, offering flexibility while delivering high‑visibility impact across multiple high‑profile accounts.

Key Responsibilities

• Client Partnership & Strategy: Develop and nurture deep relationships with senior client stakeholders, understanding their business objectives, compliance needs, and strategic roadmaps. Translate these insights into actionable consulting plans that drive Medicaid revenue optimization.
• Medicaid Claims Management: Oversee end‑to‑end Medicaid claims processing for pharmaceutical and biotech clients, ensuring accuracy, timeliness, and alignment with federal and state regulations.
• Regulatory Compliance Leadership: Serve as the subject‑matter expert on Government Contracting Compliance, continuously monitoring legislative changes, guidance documents, and audit findings to keep client programs compliant.
• Contract Management Support: Collaborate with client contract teams to interpret Medicaid agreement terms, negotiate amendments when necessary, and ensure contractual obligations are met without risk of penalties.
• Data Analysis & Reporting: Leverage advanced Excel techniques and data‑visualization tools to analyze large claims datasets, identify trends, flag anomalies, and produce executive‑level reports that drive informed decision‑making.
• Project Coordination: Lead multiple simultaneous client engagements, juggling competing priorities while maintaining strict adherence to mandated deadlines.
• Quality Assurance & Continuous Improvement: Implement rigorous QA processes, conduct periodic audits, and champion best‑practice methodologies to elevate the quality of deliverables.
• Thought Leadership & Knowledge Sharing: Create internal knowledge assets, mentor junior consultants, and represent Workwarp at industry conferences, webinars, and client workshops.
• Technology Enablement: Partner with our technology teams to evaluate, configure, and optimize Medicaid‑focused software solutions that enhance efficiency and compliance.

Essential Qualifications

• Education: Bachelor’s degree in Accounting, Finance, Business Administration, Health Economics, or a closely related discipline.
• Industry Experience: Minimum of six (6) years of hands‑on experience within the pharmaceutical or biotechnology sector, specifically working with Medicaid agreements, contracts, and claim‑submission processes.
• Compliance Expertise: Demonstrated ability to master complex government compliance frameworks (e.g., 42 CFR § 441, Medicaid State Plan Amendments, CMS guidelines) and translate these requirements into operational policies.
• Analytical Acumen: Advanced proficiency with Microsoft Excel (including pivot tables, Power Query, macros, and complex formulae) and strong comfort working with large, multi‑dimensional datasets.
• Communication Skills: Exceptional written and verbal communication abilities, capable of producing client‑ready deliverables, executive presentations, and clear documentation for diverse audiences.
• Project Management: Proven track record of managing multiple client assignments in a deadline‑driven environment, with an emphasis on prioritization, resource allocation, and risk mitigation.
• Detail Orientation: High accuracy rate and meticulous attention to detail, ensuring that every claim, report, and compliance checklist meets the highest standards.
• Technical Aptitude: Ability to understand underlying data structures, work with large data extracts, and collaborate with IT teams to implement data‑driven solutions.

Preferred Qualifications (Nice‑to‑Have)

• Master’s degree or relevant advanced certification (e.g., Certified Medicaid Specialist, CPH – Certified Professional in Healthcare Quality).
• Experience with Medicaid software platforms such as Medi‑Wise, Medicaid Management Information System (MMIS), or custom ERP solutions.
• Prior exposure to federal grant management, 340B drug pricing program, or other government‑funded healthcare initiatives.
• Professional project management certification (PMP, PRINCE2) or experience leading cross‑functional agile teams.
• Familiarity with data‑visualization tools beyond Excel, such as Tableau, Power BI, or Looker.
• Public speaking experience at industry conferences, webinars, or client training sessions.

Core Skills & Competencies for Success

• Strategic Thinking: Ability to see the big picture, anticipate regulatory shifts, and craft forward‑looking strategies that secure client revenue.
• Problem Solving: Skillful at diagnosing complex claim discrepancies, root‑cause analysis, and designing practical remediation plans.
• Collaboration: Comfortable partnering with cross‑functional stakeholders – legal, finance, IT, and operations – to deliver integrated solutions.
• Adaptability: Thrive in a fast‑changing environment, quickly learning new regulations, tools, or client processes.
• Leadership & Mentoring: Capacity to guide junior consultants, foster a learning culture, and champion best practices across the organization.
• Client‑Centric Mindset: Passion for delivering exceptional service, anticipating client needs, and exceeding expectations.

Career Growth & Learning Opportunities

Workwarp believes that the success of our people fuels the success of our clients. As a Principal Consultant, you will have a clear pathway to senior leadership roles such as Director of Medicaid Services, Head of Compliance Consulting, or Regional Practice Lead. We support continuous development through:

• Access to tuition reimbursement for advanced degrees and professional certifications.
• Regular internal and external workshops on emerging Medicaid policies, analytics, and technology trends.
• Mentorship programs that pair you with senior executives for strategic career guidance.
• Opportunities to lead high‑visibility client engagements that expand your network across the life‑sciences sector.
• Participation in Thought‑Leadership Communities where you can publish whitepapers, case studies, and industry insights.

Work Environment & Company Culture

Our remote‑first model is built on trust, autonomy, and collaboration. Key aspects of our culture include:

• Flexibility: Choose the location and schedule that best supports your productivity and work‑life integration.
• Inclusivity: A diverse workforce where every voice is valued, and inclusion initiatives create a sense of belonging.
• Innovation: A culture that encourages experimentation, the adoption of new tools, and continuous improvement.
• Recognition: Regular acknowledgment of individual and team achievements through awards, shout‑outs, and performance bonuses.
• Well‑Being: Programs that support mental health, physical wellness, and overall life satisfaction (e.g., virtual fitness classes, mindfulness workshops).

Compensation, Perks & Benefits

We offer a competitive salary commensurate with your experience, plus a comprehensive benefits package designed to support your health, financial security, and personal growth.

• Health Coverage: Medical, dental, and vision plans with generous employer contributions.
• Financial Wellness: Health Savings Account (HSA), Flexible Spending Account (FSA), matching 401(k) contributions, Employee Stock Purchase Plan (ESPP), and performance‑based bonuses.
• Paid Time Off: Generous PTO, Volunteer Time Off (VTO), and holiday schedules to recharge and give back.
• Life & Pet Protection: Life insurance, accidental death coverage, and pet insurance options.
• Employee Assistance: Confidential counseling, mental‑health programs, and wellness resources.
• Learning & Development: Access to online learning platforms, industry certifications, and internal training sessions.
• Community & Giving: Charitable giving programs, volunteer opportunities, and corporate social responsibility initiatives.

How to Apply – Your Next Step

If you are ready to leverage your Medicaid expertise, drive strategic outcomes for leading life‑science organizations, and grow within a supportive, innovative environment, we want to hear from you. The application process is straightforward:

1. Click the Apply To This Job button.
2. Submit your updated resume and a brief cover letter outlining your relevant Medicaid experience and why you are excited about the role.
3. Our talent acquisition team will review your application and contact you within 48 hours to discuss next steps.

Take the next bold step in your career—join Workwarp and become a catalyst for compliance excellence and Medicaid revenue growth across the life‑sciences landscape.

Ready to Make an Impact?

Don’t miss this opportunity to work with industry‑leading clients, collaborate with top‑tier professionals, and shape the future of Medicaid consulting from anywhere in the world. Apply today and start your journey toward a rewarding, high‑impact career with Workwarp.