Medicaid Policy & Program Analyst

Duties and Responsibilities

• Conduct detailed reviews of existing Medicaid and public assistance notices to identify policy, regulatory, operational, and compliance gaps.
• Analyze federal and state Medicaid regulations, CMS requirements, eligibility policies, and DCF business rules impacting notice content and delivery.
• Develop business and policy requirements for eligibility determinations, adverse actions, appeal rights, hearing processes, deadlines, and documentation requirements.
• Support creation of the Notice Inventory Validation and Classification Matrix, including notice categorization, prioritization, risk assessment, and impact analysis.
• Collaborate with legal, operations, and technical teams to ensure notice requirements are complete, accurate, and traceable.
• Define notice-level content requirements, business rules, reason code explanations, and program-specific language.
• Participate in stakeholder workshops, requirements sessions, governance meetings, and validation reviews.
• Support development of implementation sequencing recommendations and traceability documentation.
• Ensure notice designs align with federal compliance requirements, accessibility standards, and language access obligations.

Requirements

• 5+ years of experience supporting Medicaid eligibility, public assistance programs, healthcare policy, or human services programs.
• Strong knowledge of Medicaid eligibility processes, notices, appeals, hearings, and federal compliance requirements.
• Experience translating policy and operational requirements into business requirements and functional specifications.
• Experience conducting policy analysis, gap assessments, and requirements validation.
• Excellent facilitation, documentation, and stakeholder engagement skills.

Preferred Qualifications

• Experience supporting Medicaid Enterprise Systems (MES), eligibility systems, or integrated eligibility modernization initiatives.
• Experience working with CMS, SNAP, TANF, or public assistance programs.
• Experience supporting state government health and human services agencies.

• Bachelor’s Degree in Public Policy, Public Administration, Public Health, Health Administration, Human Services, Social Work, Government, or a related field.
• Master's degree preferred.