Managing Director - Coverage Policy & Program Design

Health Management Associates

12d

About The Position

The Managing Director (MD) provides leadership and oversight for a defined service line within the practice. This role is responsible for establishing and executing the service line’s vision, strategy, and growth plan. The MD leads a multidisciplinary team, ensures operational and financial performance, drives business development and thought leadership, and promotes a collaborative, inclusive, and high-performance culture. The MD also works across practices to advance strategic initiatives and support enterprise-wide priorities. This role will serve as one of the leaders of the Coverage Policy and Program Design service line which provides strategic guidance and analytical and operational support on federal and state health care coverage policies with a focus on the design, development, and impact of the three major public health care programs: Marketplace, Medicaid, and Medicare. The role will be principally focused on Medicaid. Coverage Policy and Program Design Specific Responsibilities Serve as the firm’s senior Medicaid policy and program design leader, providing authoritative guidance on federal and state coverage policy, program structure, and implementation considerations, and advising clients on the strategic, operational, and fiscal implications of evolving Centers for Medicare & Medicaid (CMS) rules, guidance, and waiver activity. Lead the development and growth of Medicaid‑focused offerings, identifying market opportunities, shaping solution concepts, and translating emerging federal and state policy priorities into compelling service offerings, proposals, and client engagements that drive sustained business development. Drive growth and innovation within the service line, shaping Medicaid‑focused service offerings, mentoring and developing senior staff, collaborating across practices, and leading business development efforts aligned with emerging federal and state Medicaid policy priorities. Advance the firm’s external visibility and credibility in Medicaid coverage policy and program design, leading thought leadership, contributing to public‑facing insights, and strengthening the firm’s reputation as a national leader in Medicaid policy and program innovation. Provide senior‑level leadership on complex, high‑visibility Medicaid engagements, representing the firm in executive‑level discussions with state agencies, CMS, and key stakeholders, and ensuring work products are defensible, actionable, and aligned with political and operational realities.

Requirements

Minimum of a bachelor’s degree in business, public health, healthcare administration or a related field required.
Minimum of 15 years of experience in publicly funded healthcare, including, but not limited to policy, operations, administration, compliance, research, or evaluation.
Demonstrated leadership experience managing and developing staff, as well as strong industry relationships and demonstrated ability to support business development required.
Strong leadership and people management capabilities.
Expertise in service line subject matter and consulting best practices.
Proven success in business development and client relationship management.
Excellent project and time management skills.
Exceptional communication, interpersonal, and collaboration skills.
Strong attention to detail and ability to work in a fast-paced, deadline-driven environment.
Ability to handle confidential information with discretion.

Nice To Haves

Master’s degree in a similar field is strongly preferred.
Deep Medicaid policy expertise across federal and state contexts, including eligibility and enrollment policy, benefits and coverage design, managed care and fee‑for‑service models, waiver authorities (e.g., 1115, 1915), and the operational and fiscal implications of CMS rulemaking, guidance, and sub‑regulatory actions.
Proven ability to design, assess, and implement Medicaid programs and coverage strategies that balance policy intent, beneficiary access and equity, state administrative feasibility, and financial sustainability, with demonstrated experience translating complex policy into actionable program design and implementation roadmaps.
Advanced understanding of Medicaid financing and delivery system dynamics, including rate setting and payment methodologies, value‑based purchasing, state‑directed payments, integration with Medicare and Marketplace coverage, and the intersection of coverage policy with delivery system reform and quality initiatives.
Credibility as a senior advisor to state Medicaid agencies, CMS, and other public‑sector stakeholders, with experience leading high‑stakes policy discussions, supporting stakeholder engagement and consensus building, and representing organizations in complex, politically sensitive environment
Strategic leadership in building and growing Medicaid‑focused advisory portfolios, including shaping service offerings, mentoring senior staff, integrating Medicaid expertise across multidisciplinary teams, and driving business development aligned with emerging federal and state policy priorities.

Responsibilities

Lead, supervise, and develop a multidisciplinary team, ensuring alignment with service line, practice, and enterprise goals.
Set clear performance expectations and provide ongoing coaching, feedback, and annual performance reviews.
Oversee workload distribution, resource planning, and staffing assignments to support client and business needs.
Support recruiting, onboarding, and integration of new staff, fostering connections across service lines and practices and with regions and sectors.
Support professional growth opportunities of team members.
Promote a collaborative, inclusive, and accountable team culture that reflects firm values and encourages engagement in practice- and enterprise-wide initiatives.
Ensure team members meet expectations related to utilization, revenue, quality standards, and business development contributions.
Maintain open communication, facilitate team collaboration, and create an environment that supports high performance and staff well-being.
Develop and execute the service line’s strategic vision, positioning, and growth plan.
Promote high-quality, evidence-based consulting and consistent use of data and analytics across client work.
Monitor service line financial performance, including utilization, revenue, margin, and forecasting.
Identify operational improvements and advance practice-level initiatives in partnership with senior leadership.
Support the development of tools, frameworks, and processes that strengthen service line performance and consistency.
Lead and support business development efforts, including opportunity identification, RFP review, and proposal development.
Cultivate strong client relationships and support team members’ growth in BD activities.
Drive thought leadership, elevate the service line’s market presence, and support strategic partnerships that enhance the firm’s visibility and impact.
Identify value-add opportunities within existing client engagements.
Serve as a subject matter expert on select engagements, providing strategic guidance and expertise.
Ensure quality standards are met across deliverables through review, coaching, and use of peer review processes.
Support project teams in managing scopes, budgets, timelines, and client expectations.
Evaluate client needs, develop recommendations, and guide implementation aligned with project objectives.
Ensure project financial performance aligns with expectations, including managing the budget and billable hour targets.
All other duties as assigned.