Consultant

Staffing Solutions Organization LLC (SSO)•Albany, NY

1d•Hybrid

About The Position

The Consultant will serve as the project lead for the design, development, and implementation of a comprehensive oversight and accountability framework for select New York State Medicaid care management programs. This role will support the New York State Department of Health (DOH) in operationalizing recommendations from the August 2025 Rockefeller Institute report, with a focus on data integration, performance oversight, contract modernization, and cross‑program coordination. The Consultant will work closely with DOH leadership, program staff, and data experts to strengthen oversight, align policies, and improve accountability across Medicaid care management initiatives.

Requirements

Demonstrated experience in Medicaid policy, program oversight, or healthcare delivery system reform
Strong background in data‑driven program monitoring, performance management, and contract and policy analysis
Proven ability to lead complex, multi‑stakeholder initiatives within government environments
Excellent written and verbal communication skills, including experience producing analytic and policy deliverables
Ability to work independently while coordinating closely with senior leadership and technical teams

Nice To Haves

Experience working directly with state Medicaid agencies
Familiarity with NYS Medicaid systems, data assets, or managed care oversight
Background in healthcare analytics, program evaluation, or federal Medicaid policy implementation
Experience facilitating cross‑agency or cross‑program governance bodies

Responsibilities

Identify, inventory, and document relevant NYS DOH data assets supporting care management oversight, including CMART, MMCOR, Medicaid encounter data.
Assess data completeness, quality, and interoperability to evaluate readiness for unified oversight.
Develop recommendations for data integration strategies, reporting linkages, and analytic workflows that support performance monitoring, compliance, and cost‑effectiveness.
Partner with DOH program and data leads to design standardized oversight tools, including performance reports, dashboards, and analytic products.
Define key performance indicators (KPIs), risk flags, and evaluation metrics aligned with Rockefeller Institute recommendations, federal expectations, and multi‑state best practices.
Establish processes for routine review, interpretation, and action on analytics by DOH leadership and program teams, including coordination with governance bodies.
Support the creation and launch of the Care Management Coordinating Committee recommended in the Rockefeller report.
Define committee mission, scope, governance, and operating norms.
Recruit committee members across DOH divisions on behalf of the Medicaid Director.
Develop initial agendas, workplans, and priority action items.
Facilitate early meetings and ensure the committee becomes a sustainable cross‑program coordination mechanism.
Conduct a comprehensive review of care management‑related requirements within mainstream Medicaid managed care contracts.
Identify gaps, redundant provisions, outdated or misaligned requirements.
Develop proposed updates to contract language, performance standards, reporting requirements, and accountability mechanisms consistent with operational realities, federal guidance, and Rockefeller report findings.
Serve as a subject‑matter expert on federal Medicaid policy developments, including CMS guidance, regulatory updates, and waiver requirements.
Advise DOH on operational and policy implications of federal changes affecting care management programs.