Medicaid Physician Consultant - Payment Policy & Rate Development

About the role

This is a unique opportunity for a physician leader with deep Medicaid expertise to support complex payment policy, rate development, financing, and program design initiatives. The role involves influencing Medicaid strategy at a broader level while working alongside states, health plans, and other key stakeholders.

Requirements

• Current or former Medical Director
• Deep experience with Medicaid program operations
• Experience supporting rate setting, payment policy, financing, and program design
• Strong understanding of healthcare reimbursement and Medicaid delivery systems
• Experience evaluating clinical trends, pharmacy programs, quality metrics, and cost drivers
• Background monitoring program performance to ensure quality outcomes and effective care delivery
• MD or DO required

Qualifications

This opportunity is particularly well-suited for physicians who have served in leadership roles within:

• State Medicaid agencies
• Medicaid managed care organizations
• Health plans with significant Medicaid populations
• Organizations focused on Medicaid payment reform and program strategy

Skills

• Clinical background as a Primary Care Provider, OB/GYN, or Behavioral Health clinician (preferred)

Why Consider It

• Opportunity to shape Medicaid policy and reimbursement strategy
• Work on high-profile state and payer initiatives
• Influence program design, financing, and quality improvement efforts
• Collaborate with healthcare leaders across the country
• Strong visibility and long-term growth potential

Important: This role requires both Medical Director experience and significant Medicaid expertise. Candidates without a Medicaid background AND physician leadership experience will not be considered.