Associate Director/Director, Medicaid Entitlement & Coverage Strategy

The Associate Director/Director of Medicaid Entitlement & Coverage Strategy leads the organization's strategic response to federal Medicaid changes, focusing on Medicaid qualification, documentation protocols, and program evaluation across multiple states. This role requires navigating state systems, implementing training, and building infrastructure to support Medicaid enrollment and redetermination.

Location: Remote (US)

Salary: $72k–$130k

Responsibilities

• Lead GRT's application process to become a Medicaid QE in all operating states, including working with legal counsel and ensuring compliance.
• Oversee SOAR training implementation across states, ensuring staff are equipped to assist with SSDI/SSI applications.
• Develop and maintain a standardized medical frailty documentation protocol.
• Lead development of systems and workflows to help eligible members meet Medicaid requirements.
• Support tracking legislation, regulations, and guidance related to Medicaid work requirements and policies.
• Translate policy developments into operational updates for GRT teams.
• Interact with state Medicaid agencies and stakeholders on QE enrollment, redetermination, and coverage strategies.
• Design and maintain an internal tracking system for members at risk of losing Medicaid coverage.
• Develop and deliver training resources on QE processes, documentation, and SSDI/SSI application assistance.
• Develop and maintain an evaluation framework to measure coverage retention, redetermination outcomes, and other metrics.
• Supervisory responsibilities to be determined.
• Occasional travel to GRT states for meetings, training, or site visits.
• Pursue ACA Marketplace Navigator certification for staff in non-expansion states.
• Other duties as assigned.

Requirements

• Knowledge of Medicaid policy, eligibility, presumptive eligibility, redeterminations, and the ACA.
• Knowledge of SSDI and SSI eligibility and application processes.
• Understanding of opioid use disorder treatment landscape and Medicaid funding.
• Experience managing complex, multi-state initiatives with multiple stakeholders.
• Experience working with state government officials and Medicaid agencies.
• Excellent communication skills, both written and verbal.
• Proficiency in project management tools and electronic health record platforms.
• Ability to work cross-functionally in a fast-paced, remote environment.
• Self-starter with ability to build and lead a program with limited direction.
• Ability to work independently and use discretion.
• Understanding and adherence to the Code of Conduct.