Associate Director/Director, Medicaid Entitlement & Coverage Strategy

Responsibilities

• Lead GRT's application process to become a Medicaid QE in all operating states where eligible, including working with GRT's legal counsel to submit Memoranda of Understanding (MOUs) to each state Medicaid agency, coordinating staff training, and ensuring ongoing compliance with state QE requirements
• Oversee the implementation of SOAR training for designated staff across all operating states, ensuring trained staff are registered and equipped to assist members with SSDI and SSI applications; establish pre-release SSDI/SSI application pipelines through GRT's corrections partnerships where applicable
• In partnership with GRT's medical and product leadership, develop, implement, and maintain a standardized medical frailty documentation protocol, ensuring the protocol is embedded into intake and annual review workflows across all Medicaid expansion states
• Lead the development and implementation of systems, workflows, and member support strategies designed to help eligible members meet state Medicaid requirements. This includes identifying at-risk members, tracking compliance milestones, facilitating documentation of qualifying activities and exemptions, working with field teams to coordinate referrals to community resources, and working with operational teams to reduce avoidable coverage losses
• Support GRT's Government Affairs team by assisting with tracking federal and state legislation, regulations, and guidance related to Medicaid work requirements, presumptive eligibility, and One Big Beautiful Bill Act implementation across all operating states
• Collaborate with the Government Affairs Team in translating policy developments into actionable operational updates for GRT's teams in a timely manner
• Pursue ACA Marketplace Navigator certification for designated staff in GRT's non-expansion states to support members who are not eligible for Medicaid

Qualifications

• Demonstrated knowledge of Medicaid policy, eligibility criteria, presumptive eligibility, redeterminations, the Affordable Care Act, including the differences between expansion and non-expansion states
• Understanding of the opioid use disorder (OUD) treatment landscape and the potential role of Medicaid in funding Substance Use Disorder (SUD)/OUD treatment services
• Demonstrated ability to manage complex, multi-state initiatives with competing deadlines and multiple stakeholders
• Experience working directly with state government officials and Medicaid agencies
• Excellent written and verbal communication skills, including the ability to present complex information clearly to diverse audiences
• Proficiency in project management tools, tracking systems, and electronic health record platforms
• Ability to work cross-functionally across clinical, medical, operational, and administrative teams in a fast-paced, remote organization
• Self-starter with the ability to build and lead a program from the ground up with limited direction
• Ability to use discretion and work independently
• Ability to understand and adhere to the Code of Conduct