The Senior Consultant will serve as the Lewin-side Medicaid lead/counterpart to CMMI staff for various models, moving Medicaid policy, technical assistance, and operational work forward across task teams. This person should be an experienced individual contributor who can independently structure ambiguous work, advise CMS, coordinate SMEs, and deliver high-quality work.
You'll enjoy the flexibility to work remotely* from anywhere within the U.S. as you take on some tough challenges. For all hires in the
Minneapolis or Washington, D.C. area, you will be required to
work in the office a minimum of four days per week .
Primary Responsibilities:- Serve as a senior Medicaid policy and implementation advisor supporting various models including the Transforming Maternal Health Model (TMaH), working closely with CMS Innovation Center staff and Lewin task leads to advance Medicaid-related priorities
- Lead and coordinate Medicaid work across TMaH 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 (with a maternal health focus)
- 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
- Translate model policy and methodology into clear data specifications, business rules, and code for core payment model functions, including beneficiary attribution, payment calculations, and quality measurement
- Lead continued development on data-based simulation modeling to support TMaH model decision making for model cost-effectiveness and cost-neutrality
- Understand Medicaid data, quality measurement, or program monitoring sufficiently to interpret analytic findings and incorporate them into policy recommendations
- Experience and understanding with CMCS Core Set, CCSQ Quality Strategy, Digital quality measurement strategy and/or electronic clinical quality measure decision support tools
- 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
- Summarize analytic findings and methodology for technical and non-technical audiences, including memos, tables, and presentation materials 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, 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
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required 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, with 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
- 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
Preferred Qualifications:- 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 practical 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 efficiently manage competing priorities and balance the needs of multiple stakeholders
- Consulting experience managing multiple concurrent assignments and responding to evolving federal client priorities
- Solid written communication skills, including experience drafting policy memoranda, issue briefs, implementation guidance, presentations, or similar client-facing materials
- 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
- Ability to work effectively both independently and collaboratively in a multidisciplinary project environment
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $112,700 - $193,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.
