Manager, Medicaid Policy and Payment Model Implementation - Remote

UnitedHealth Group•Reston, VA

2d•$112,700 - $193,200•Remote

About The Position

OptumServe Consulting/The Lewin Group (OSC/Lewin) is a premier national health care and human services consulting and policy analysis firm with 50 years of experience. They provide strategic and analytical services to clients in the public, non-profit, and private sectors. OSC/Lewin has over 250 consultants and is committed to objectivity, integrity, analytical innovation, vision, and client satisfaction. They assist federal decision-makers in strengthening health and human services programs, making informed policy choices, and implementing critical initiatives. OSC/Lewin also conducts research and evaluations for foundations and associations, delivering data-driven research, program planning, technical assistance, implementation support, post-implementation analytics, and evaluations to improve the health and well-being of citizens. The Senior Consultant will act as the Lewin-side Medicaid lead for the AHEAD model, working with CMMI staff to advance Medicaid policy, technical assistance, and operational work. This role requires an experienced individual contributor capable of structuring ambiguous work, advising CMS, coordinating SMEs, and delivering high-quality results. The position offers the flexibility to work remotely from anywhere within the U.S.

Requirements

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
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
Demonstrated 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
Demonstrated ability to provide policy consultation and develop clear, well-supported options and recommendations for senior clients or decision-makers
Proven solid written communication skills, including experience drafting policy memoranda, issue briefs, implementation guidance, presentations, or similar client-facing materials
Proven solid verbal communication and facilitation skills, with the ability to translate complex policy and operational issues for technical and non-technical audiences
Demonstrated attention to detail and ability to produce accurate, high-quality work in a fast-moving client-service environment
Proven ability to work effectively both independently and collaboratively in a multidisciplinary project environment

Nice To Haves

Experience supporting a CMS Innovation Center model or another federal healthcare demonstration
Direct experience with state-based transformation, multi-payer alignment, hospital global budgets, advanced primary care, accountable care, or total cost of care accountability
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
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 practical implementation tools, such as readiness assessments, roadmaps, decision frameworks, issue trackers, or operational guidance
Experience collaborating with attorneys, actuaries, clinicians, data analysts, payment-methodology experts, and operations teams
Consulting experience managing multiple concurrent assignments and responding to evolving federal client priorities
Knowledge of Medicaid managed care and fee-for-service delivery systems
Familiarity with Medicaid authorities and implementation mechanisms, such as state plan amendments, Section 1115 demonstrations, managed care authorities, or state-directed payment arrangements
Familiarity with Medicaid data, quality measurement, or program monitoring sufficient to interpret analytic findings and incorporate them into policy recommendations

Responsibilities

Serve as a senior Medicaid policy and implementation advisor supporting the AHEAD Model, working closely with CMS Innovation Center staff and Lewin task leads to advance Medicaid-related priorities
Lead and coordinate Medicaid work across AHEAD task teams, establishing work plans, clarifying responsibilities, identifying dependencies, and driving activities through completion
Provide policy consultation, structured analysis, and thought partnership to 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
Analyze federal and state Medicaid policies, authorities, programs, and implementation approaches, including state plan and waiver considerations, and translate findings into clear options, recommendations, and decision materials
Support the development and refinement of Medicaid policies and operational approaches that account for differences in state delivery systems, including Medicaid fee-for-service and managed care environments
Design and lead technical assistance strategies that help states and other stakeholders implement Medicaid payment and delivery-system reforms and improve health and human service delivery programs
Develop and review high-quality technical assistance products, including policy memos, issue briefs, implementation roadmaps, guidance documents, presentations, webinars, frequently asked questions, and other stakeholder-facing materials
Facilitate discussions with CMS, state partners, subject-matter experts, contractors, and internal teams to resolve open policy and operational questions and build alignment around recommended approaches
Translate complex Medicaid policy and payment issues for technical and non-technical audiences, clearly distinguishing policy decisions, operational implications, risks, dependencies, and unresolved questions
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, maintaining a high degree of quality and attention to detail
Support and mentor colleagues across task teams by providing Medicaid subject-matter guidance, structured problem-solving support, and review of work products
Contribute to broader project planning, client relationship development, and proposal or business-development activities, as needed