Remote Medicaid Policy & Payment Model Lead

RXinsider LTD.; Reston (VA); Remote; USD 113,000 - 193,000; Full time

Benefits offered by this job

Comprehensive benefits package

Stock purchase and 401k options

Job summary

OptumServe Consulting/The Lewin Group (OSC/Lewin) seeks a Senior Medicaid policy and implementation advisor to lead cross-cutting Medicaid initiatives, coordinate across AHEAD task teams, and deliver policy guidance to CMS and state partners.

You will translate complex policy into actionable recommendations, develop technical assistance products, and mentor junior staff in a dynamic federal healthcare consulting environment.

Qualifications

• 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.

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

Skills

Medicaid policy

Policy analysis

Stakeholder engagement

Project leadership

Policy communication

Cross-functional teamwork

Written communication

Verbal facilitation

Job description

OptumServe Consulting/The Lewin Group (OSC/Lewin) seeks a Senior Medicaid policy and implementation advisor to lead cross-cutting Medicaid initiatives, coordinate across AHEAD task teams, and deliver policy guidance to CMS and state partners.

You will translate complex policy into actionable recommendations, develop technical assistance products, and mentor junior staff in a dynamic federal healthcare consulting environment.