Manager, Medicaid Policy and Payment Model Implementation - Remote

UnitedHealth Group•Washington, DC

4d•$112,700 - $193,200•Remote

About The Position

OptumServe Consulting/The Lewin Group (OSC/Lewin), a national health care and human services consulting and policy analysis firm, supports federal, state, nonprofit, and private-sector clients with objective, data-driven research, program planning, technical assistance, implementation, analytics, and evaluation. The Senior Consultant will serve as the Lewin-side Medicaid lead and counterpart to CMS Innovation Center staff for various models, advancing Medicaid policy, technical assistance, and operational work across task teams. This experienced individual contributor will independently structure ambiguous work, advise CMS, coordinate subject-matter experts, and deliver high-quality work. The role supports Medicaid policy and implementation for models including the Transforming Maternal Health Model (TMaH). It involves advising on payment and delivery-system reforms, analyzing federal and state Medicaid policy, translating policy and methodology into operational specifications and code, and supporting data-based simulation modeling for model decisions. The position also leads technical assistance and develops stakeholder-facing materials, facilitates alignment among CMS, states, experts, contractors, and internal teams, and supports colleagues and broader project activities. The role is remote from anywhere in the U.S. However, hires in the Minneapolis or Washington, D.C. area must work in the office at least four days per week. Remote employees must follow UnitedHealth Group’s Telecommuter Policy. The advertised annual salary range is $112,700–$193,200 for full-time employment, with compensation dependent on factors including location, education, experience, and certifications.

Requirements

At least 6 years of relevant professional experience in Medicaid policy, health policy consulting, government programs, technical assistance, program implementation, healthcare delivery transformation, or a related field.
At least 2 years of direct experience working with T-MSIS data.
Demonstrated experience analyzing Medicaid policy, program design, payment policy, delivery systems, or operational implementation.
Experience supporting the design, implementation, evaluation, or operation of alternative payment models, value-based care programs, or other healthcare payment and delivery-system reforms.
Ability to independently lead complex workstreams, organize ambiguous assignments, manage competing priorities, and drive work to completion.
Experience leading cross-functional teams or coordinating work across multiple teams and subject-matter experts without direct reporting authority.
Ability to provide policy consultation and develop clear, well-supported options and recommendations for senior clients or decision-makers.
Remote employees must adhere to UnitedHealth Group’s Telecommuter Policy.
Candidates must pass a drug test before beginning employment.

Nice To Haves

Experience supporting a CMS Innovation Center model or another federal healthcare demonstration.
Experience working in or directly supporting a state Medicaid agency, CMS, CMCS, CMMI, a Medicaid managed care organization, or a Medicaid policy or technical-assistance contractor.
Knowledge of Medicaid managed care and fee-for-service delivery systems.
Understanding of maternal health and global billing practices in state Medicaid contexts.
Familiarity with Medicaid authorities and implementation mechanisms, such as state plan amendments, Section 1115 demonstrations, managed care authorities, or state-directed payment arrangements.
Experience advising federal or state clients on policy design, implementation options, operational feasibility, and stakeholder implications.
Experience designing or delivering technical assistance to states, health plans, providers, hospitals, primary care practices, or other healthcare stakeholders.
Experience developing implementation tools such as readiness assessments, roadmaps, decision frameworks, issue trackers, or operational guidance.
Experience collaborating with policy makers, state health officials, actuaries, clinicians, data analysts, payment-methodology experts, and operations teams.
Familiarity with CMCS Core Set, CCSQ Quality Strategy, Digital quality measurement strategy, and/or electronic clinical quality measure decision support tools.
Ability to manage competing priorities and balance multiple stakeholder needs.
Consulting experience managing multiple concurrent assignments and responding to evolving federal client priorities.
Written communication skills, including drafting policy memoranda, issue briefs, implementation guidance, presentations, or similar client-facing materials.
Verbal communication and facilitation skills, including translating complex policy and operational issues for technical and non-technical audiences.
Attention to detail and ability to produce accurate, high-quality work in a fast-moving client-service environment.
Ability to work independently and collaboratively in a multidisciplinary project environment.

Responsibilities

Serve as a senior Medicaid policy and implementation advisor for models including TMaH, working with CMS Innovation Center staff and Lewin task leads.
Lead and coordinate Medicaid work across TMaH task teams by establishing work plans, clarifying responsibilities, identifying dependencies, and driving activities to completion.
Advise CMS on Medicaid payment and delivery-system reforms, including alternative payment models, value-based care, hospital global budgets, advanced primary care, and multi-payer alignment, with a maternal health focus.
Analyze federal and state Medicaid policies, authorities, programs, and implementation approaches, including state plan and waiver considerations, and develop options, recommendations, and decision materials.
Translate model policy and methodology into data specifications, business rules, and code for payment model functions such as beneficiary attribution, payment calculations, and quality measurement.
Lead continued development of data-based simulation modeling to support TMaH decisions about cost-effectiveness and cost-neutrality.
Interpret analytic findings related to Medicaid data, quality measurement, or program monitoring and incorporate them into policy recommendations.
Support development and refinement of Medicaid policies and operational approaches that account for state delivery-system differences, including fee-for-service and managed care.
Design and lead technical assistance strategies to help states and other stakeholders implement Medicaid payment and delivery-system reforms and improve health and human services programs.
Develop and review technical assistance products, including policy memos, issue briefs, implementation roadmaps, guidance, presentations, webinars, and FAQs.
Facilitate discussions with CMS, state partners, subject-matter experts, contractors, and internal teams to resolve policy and operational questions and build alignment.
Explain complex Medicaid policy and payment issues to technical and non-technical audiences, distinguishing decisions, operational implications, risks, dependencies, and open questions.
Summarize analytic findings and methodology for technical and non-technical audiences, including through memos, tables, and presentations for CMS.
Identify implementation risks, policy gaps, and emerging issues; develop options and recommendations; and elevate decisions requiring CMS direction.
Review deliverables for accuracy, consistency, policy alignment, and practical usability.
Support and mentor colleagues across task teams through Medicaid subject-matter guidance, structured problem-solving, and work-product review.
Contribute as needed to project planning, client relationship development, and proposal or business-development activities.