[Remote] Senior Medicaid Policy Consultant / Medicaid SME

Note: The job is a remote job and is open to candidates in USA. HealthCare Recruiters International is recruiting for a national healthcare consulting organization seeking a Senior Medicaid Policy Consultant / Medicaid SME. The role provides strategic and technical expertise to State Medicaid Agencies on policy, program implementation, federal compliance, financing, and delivery system initiatives.

Responsibilities

• Advising State Medicaid Agencies on Medicaid policy, strategy, and implementation
• Interpret federal Medicaid statutes, regulations, CMS guidance, and federal requirements
• Support the development and implementation of State Plan Amendments (SPAs), 1115 demonstrations, and 1915 waivers
• Provide expertise related to Medicaid financing and funding, managed care, delivery systems, and federal compliance
• Research and analyze Medicaid regulations and policy changes and develop recommendations for state clients
• Develop and review Medicaid policy documents, regulatory analyses, waiver materials, and client deliverables
• Work with CMS, state leadership, legislators, health plans, providers, and other Medicaid stakeholders
• Review the work of other consultants for accuracy, quality, and regulatory compliance
• Mentor and provide technical guidance to Medicaid consulting teams

Skills

• 20+ years of progressive Medicaid experience, including significant experience working directly within a State Medicaid Agency and/or CMS
• Senior Medicaid leadership experience, ideally as a State Medicaid Director or Deputy Medicaid Director, with responsibility for Medicaid policy, programs, financing and/or operations
• Broad, enterprise-level knowledge of Medicaid policy, federal regulations, financing, delivery systems, program operations and compliance
• Experience interpreting and implementing federal Medicaid laws, regulations, and CMS guidance
• Experience developing, reviewing, or implementing State Plan Amendments (SPAs), 1115 waivers, 1915 waivers, and other Medicaid authorities
• Knowledge of Medicaid managed care, HCBS, LTSS, behavioral health, eligibility, benefits, and/or provider policy
• Experience working with CMS and state/federal government stakeholders
• Strong Medicaid policy research, analysis, and written communication skills
• Demonstrated ability to remain hands-on with complex Medicaid policy and regulatory work
• Experience mentoring, reviewing, and developing the work of other Medicaid professionals

Benefits

• Remote

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