Manager, Medicaid Financing and Policy

CBIZ•Kansas City, MO

16h•Hybrid

About The Position

Myers and Stauffer is seeking a Manager to join our Rate Setting and Federal Compliance engagement team. In this role you will lead the design, modeling, and documentation of Medicaid payment arrangements for state Medicaid agency clients, including state directed payments, upper payment limit demonstrations, supplemental payments, and the non-federal share arrangements that fund them. We work for government. Our clients are state Medicaid agencies and federal partners, not providers. That shapes the work. Every analysis has to withstand CMS review, survive audit, and hold up when a state has to defend it publicly. Our work is analytical, collaborative, and iterative.

Requirements

High school diploma or GED

Nice To Haves

Bachelor's degree in accounting, finance, health policy, health informatics, data analytics, business intelligence/analysis, statistics, economics, public health, or a related field.
Demonstrated experience in healthcare reimbursement, Medicaid policy, or government healthcare analytics.
Five or more years of experience in Medicaid or healthcare reimbursement, health policy, or government healthcare consulting, including at least two years working directly on Medicaid financing, supplemental payments, directed payments, or upper payment limit work
Working knowledge of how the non-federal share is generated and the constraints that apply, including health care-related taxes, intergovernmental transfers, and certified public expenditures
Experience preparing or reviewing State Plan Amendments, directed payment preprints, or responses to CMS
Familiarity with Medicaid payment methodologies such as DRG, EAPG, APC, RBRVS, per diem, average commercial rate, and cost-based clinic prospective payment
Rate setting experience in hospital, physician, clinic, or other service lines
Experience with Medicare and Medicaid cost reports and with large Medicaid claims datasets
Proficiency in SQL, Alteryx, PowerBI, or comparable tools
Prior experience working with or within a state Medicaid agency
Clear writing for a policy audience, including technical documentation and regulatory submissions
Ability to manage several concurrent deadlines and reprioritize as client needs shift
Ability to incorporate feedback, refine work, and continuously improve

Responsibilities

Own the analytic approach on assigned engagements, from the client question through the final deliverable
Translate federal regulation and state policy objectives into workable payment methodologies
Set assumptions, test them, and document why they are defensible
Review analyst work and give feedback that builds technical judgment, not just corrections
Explain technical results to state staff who are not analysts
Improve processes, workflows, and documentation across engagements
Lead the design, calculation, and documentation of Medicaid payment methodologies for hospitals, physicians, clinics, and other provider types
Develop and maintain upper payment limit demonstrations, including gap calculations across ownership categories and service settings
Support state directed payment development, including preprint preparation, evaluation plans, and responses to CMS questions
Model supplemental and directed payment arrangements together with their financing sources, including health care-related taxes, intergovernmental transfers, and certified public expenditures
Analyze how a proposed payment change moves through the non-federal share, the federal match, and the provider net position, and identify where the arrangement is exposed
Draft State Plan Amendments, preprints, methodology descriptions, and responses to CMS requests for additional information
Research federal statute, regulation, State Medicaid Director letters, and CMS guidance, then apply them to client-specific facts
Estimate fiscal impact for proposed payment and financing changes, including multi-year projections
Review analyses prepared by staff for accuracy, methodology, and documentation quality
Manage engagement timelines, budgets, and client communication on assigned projects
Present findings to state Medicaid agency staff and support client presentations to legislatures, provider associations, and CMS
Mentor and develop analysts. Direct supervisory responsibility may be assigned as the team grows
Maintain accurate, organized electronic documentation
Maintain strict confidentiality and security of protected health information
Perform additional responsibilities as assigned
Track federal rulemaking affecting Medicaid financing and translate it into practical client impact. Recent examples include CMS rulemaking on state directed payments and on health care-related tax hold harmless standards
Contribute to internal methodology standards, templates, and quality review procedures
Provide subject matter input to proposals and technical approach sections as requested