Manager, Medicaid Financing and Policy

#LI-Hybrid #LI-MM3

Myers and Stauffer is seeking a Manager to join our Rate Setting and Federal Compliance engagement team. In this role you will lead the design, modeling, and documentation of Medicaid payment arrangements for state Medicaid agency clients, including state directed payments, upper payment limit demonstrations, supplemental payments, and the non-federal share arrangements that fund them.

We work for government. Our clients are state Medicaid agencies and federal partners, not providers. That shapes the work. Every analysis has to withstand CMS review, survive audit, and hold up when a state has to defend it publicly.

Our work is analytical, collaborative, and iterative. As a Manager, you will regularly:

• Own the analytic approach on assigned engagements, from the client question through the final deliverable
• Translate federal regulation and state policy objectives into workable payment methodologies
• Set assumptions, test them, and document why they are defensible
• Review analyst work and give feedback that builds technical judgment, not just corrections
• Explain technical results to state staff who are not analysts
• Improve processes, workflows, and documentation across engagements

Essential Functions and Primary Duties:

• Lead the design, calculation, and documentation of Medicaid payment methodologies for hospitals, physicians, clinics, and other provider types
• Develop and maintain upper payment limit demonstrations, including gap calculations across ownership categories and service settings
• Support state directed payment development, including preprint preparation, evaluation plans, and responses to CMS questions
• Model supplemental and directed payment arrangements together with their financing sources, including health care-related taxes, intergovernmental transfers, and certified public expenditures
• Analyze how a proposed payment change moves through the non-federal share, the federal match, and the provider net position, and identify where the arrangement is exposed
• Draft State Plan Amendments, preprints, methodology descriptions, and responses to CMS requests for additional information
• Research federal statute, regulation, State Medicaid Director letters, and CMS guidance, then apply them to client-specific facts
• Estimate fiscal impact for proposed payment and financing changes, including multi-year projections
• Review analyses prepared by staff for accuracy, methodology, and documentation quality
• Manage engagement timelines, budgets, and client communication on assigned projects
• Present findings to state Medicaid agency staff and support client presentations to legislatures, provider associations, and CMS
• Mentor and develop analysts. Direct supervisory responsibility may be assigned as the team grows
• Maintain accurate, organized electronic documentation
• Maintain strict confidentiality and security of protected health information
• Perform additional responsibilities as assigned
• Track federal rulemaking affecting Medicaid financing and translate it into practical client impact. Recent examples include CMS rulemaking on state directed payments and on health care-related tax hold harmless standards
• Contribute to internal methodology standards, templates, and quality review procedures
• Provide subject matter input to proposals and technical approach sections as requested

Preferred Qualifications:

• Bachelor's degree in accounting, finance, health policy, health informatics, data analytics, business intelligence/analysis, statistics, economics, public health, or a related field.
• Demonstrated experience in healthcare reimbursement, Medicaid policy, or government healthcare analytics.
• Five or more years of experience in Medicaid or healthcare reimbursement, health policy, or government healthcare consulting, including at least two years working directly on Medicaid financing, supplemental payments, directed payments, or upper payment limit work
• Working knowledge of how the non-federal share is generated and the constraints that apply, including health care-related taxes, intergovernmental transfers, and certified public expenditures
• Experience preparing or reviewing State Plan Amendments, directed payment preprints, or responses to CMS
• Familiarity with Medicaid payment methodologies such as DRG, EAPG, APC, RBRVS, per diem, average commercial rate, and cost-based clinic prospective payment
• Rate setting experience in hospital, physician, clinic, or other service lines
• Experience with Medicare and Medicaid cost reports and with large Medicaid claims datasets
• Proficiency in SQL, Alteryx, PowerBI, or comparable tools
• Prior experience working with or within a state Medicaid agency
• Clear writing for a policy audience, including technical documentation and regulatory submissions
• Ability to manage several concurrent deadlines and reprioritize as client needs shift
• Ability to incorporate feedback, refine work, and continuously improve

Minimum Qualifications

• High school diploma or GED