Medicaid and Children's Waiver Subject Matter Expert (SME)

Briljent • Indianapolis, IN

9d

About The Position

The Medicaid and Children's Waiver Subject Matter Expert (SME) supports a state health agency client in the design, establishment, and operationalization of a new Medicaid Bureau. Operating within an integrated consulting team, this individual takes direction from client leadership to shape policy, operational frameworks, payment reform, and implementation deliverables. The role carries a high degree of independent content ownership, with all work performed in coordination with the broader consulting team and project leadership to ensure unified delivery to the client.

Requirements

• Deep knowledge of state Medicaid policy, including managed care, fee-for-service delivery systems, waiver authorities, care management programs, and Medicaid program administration
• Expertise with home and community based services (HCBS) waiver programs, including eligibility, care management, provider requirements, and operational implementation considerations
• Ability to analyze complex policy, operational, financing, and programmatic considerations and translate findings into actionable recommendations
• Exceptional written and verbal communication skills, with the ability to produce polished, client-ready materials
• Experience with New York State (NYS) Medicaid policy strongly preferred; equivalent experience with Medicaid policy in other states will be considered
• Demonstrated expertise with the New York State Children's Waiver, including HCBS services, eligibility, care management, provider requirements, and operational implementation
• Experience supporting programs serving children with medical complexity, medically fragile children, and other high-need pediatric populations
• Experience supporting the design, structuring, or operational establishment of state government units or bureaus, including program documentation, operational guidance, and implementation planning
• Significant experience developing Medicaid policies, operational guidance, and implementation plans, with a proven track record of drafting complex, client-facing deliverables
• Experience evaluating and developing Medicaid payment reform strategies, reimbursement approaches, care delivery models, alternative payment methodologies, or value-based payment (VBP) arrangements
• Must be eligible to work in the United States. No sponsorships are available at this time.

Responsibilities

• Takes strategic direction from client leadership to help define the vision, operational approach, and overall goals for the new Medicaid Bureau
• Facilitates structured discussions with state Medicaid agencies and key stakeholders to align deliverables with client expectations, policy requirements, and organizational objectives
• Serves as a trusted thought partner to the client, translating complex state priorities and emerging concepts into actionable program plans
• Collaborates with the broader consulting team, participating in strategic team planning, peer reviews, and quality assurance processes to deliver cohesive, firm-backed solutions
• Acts as the primary author of critical workstream content, independently drafting and revising policy documents, operational guidance, and implementation frameworks from concept to client-ready completion
• Maintains and drives detailed project workplans, working with team leadership to proactively identify, track, and mitigate project risks, dependencies, and outstanding policy questions
• Develops strategic recommendations regarding Medicaid payment reform, reimbursement approaches, care delivery models, and alternative payment methodologies (APMs)
• Translates complex regulatory and policy concepts into structured analyses, operational blueprints, and practical guidance documents for the Bureau's staff

What This Job Offers

• Job Type: Part-time
• Career Level: Senior
• Education Level: No Education Listed