Associate Director, Healthcare Finance (Medicaid Strategy & Financing, Managed Care and Policy & Reimbursement)

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Associate Director, Healthcare Finance (Medicaid Strategy & Financing, Managed Care and Policy & Reimbursement) based in United States.

This is a senior healthcare consulting role focused on Medicaid strategy, financing, managed care, and provider policy and reimbursement. You will lead complex client engagements and provide objective, data-driven advice to healthcare organizations, government stakeholders, and industry partners. The role combines healthcare policy expertise with sophisticated financial modeling, quantitative analysis, and strategic problem-solving. You will work directly with senior executives and public-sector leaders to evaluate reimbursement structures and develop sustainable financing strategies. As a hands-on subject matter expert, you will also contribute to business development, project leadership, and the development of junior team members. The environment is collaborative, highly analytical, and mission-driven, with the opportunity to influence healthcare policy and improve outcomes for underserved populations.

Accountabilities:

• Lead and deliver complex healthcare consulting engagements focused on Medicaid strategy and financing, managed care, provider reimbursement, healthcare policy, and related financial and operational challenges, maintaining high standards of quality and client satisfaction.
• Serve as a trusted advisor to senior client stakeholders, including CEOs, CFOs, reimbursement leaders, Medicaid directors, government officials, state consultants, actuaries, associations, and other decision-makers, providing objective guidance on financial and policy matters.
• Analyze existing reimbursement methodologies and financial records, identify alternative Medicaid financing approaches, and develop recommendations that reflect changing federal and state regulations, payment principles, and client objectives.
• Develop and oversee sophisticated financial models that support forecasting, budgeting, resource allocation, scenario analysis, and strategic decision-making, including dynamic models that allow stakeholders to evaluate multiple financing scenarios.
• Calculate federal and non-federal shares of Medicaid payments, evaluate payment structures, analyze healthcare payer data, conduct statistical testing, and incorporate both publicly available and proprietary datasets into financial and policy analyses.
• Establish and maintain rigorous quality assurance processes for financial models and analytical outputs, ensuring accuracy, appropriate data handling, HIPAA compliance, secure data transfer, and reliable support for client decisions.
• Support the development and implementation of Medicaid payment strategies, including managed care directed payment programs, graduate medical education, physician upper payment limit demonstrations, provider assessments, supplemental payment approaches, and other financing mechanisms.
• Interpret federal and state guidance, CMS rulings, Medicaid State Plan Amendments, Pre-Prints, waivers, healthcare taxes, payment requirements, and other regulatory developments, translating complex policy changes into practical recommendations.
• Serve as a primary technical and financial project contact when assigned, managing communications, deliverables, project plans, stakeholder expectations, and overall engagement success with limited supervision.
• Support proposal development, scope definition, budgeting, cost estimation, sales assessments, presentations, and business development activities while translating complex technical concepts into clear and compelling information for non-technical audiences.
• Identify opportunities to expand existing client relationships and develop new business by applying industry knowledge, policy awareness, professional networks, and understanding of evolving healthcare market needs.
• Collaborate with legal, regulatory, compliance, technical, and consulting teams to develop solutions that are practical, analytically sound, and aligned with applicable legal and ethical requirements.
• Lead, mentor, and develop direct reports by strengthening technical capabilities, providing constructive feedback, managing utilization, balancing workloads, and supporting long-term professional development.
• Conduct ad hoc analyses related to healthcare investments, reimbursement methodologies, Medicaid financing, and market developments that may directly or indirectly affect supplemental payments and healthcare business performance.

Requirements:

• Bachelor’s degree with 10 or more combined years of experience in public healthcare policy management, healthcare consulting, health or human services policy or finance, healthcare service delivery, Medicaid managed care, or a related environment. Alternatively, 5+ years of progressively responsible post-graduate consulting or operational experience in healthcare and/or health policy research and analysis.
• Extensive knowledge of Medicaid financing and payment structures, including managed care directed payments, graduate medical education, physician upper payment limit demonstrations, disproportionate share hospital payments, fee-for-service upper payment limits, provider assessments, supplemental payments, and value-based or quality-based payment considerations.
• Strong understanding of allowable non-federal share funding sources, including intergovernmental transfers, provider assessments, and certified public expenditures, as well as Medicaid waivers and commercial reimbursement principles.
• Experience interpreting CMS requirements and federal and state healthcare regulations, including State Plan Amendments, Pre-Prints, submission timelines, data requirements, CMS rulings, healthcare taxes, and payment guidance.
• Demonstrated ability to develop sophisticated, dynamic financial models using large healthcare datasets and clearly communicate model outputs, assumptions, scenarios, and recommendations to both technical and executive audiences.
• Experience working with healthcare data such as claims datasets, cost reports, Medicare Hospital Cost Reports, CMS physician fee schedules, public-use files, and other publicly available or proprietary healthcare datasets.
• Strong knowledge of medical billing terminology and healthcare financial processes, along with an understanding of data security, storage, confidentiality, and appropriate handling of sensitive client information.
• Advanced proficiency in Microsoft Excel and Word, with experience using quantitative and analytical tools to support financial modeling, research, evaluation, and strategic decision-making. Experience with SQL or other querying languages for large healthcare datasets is preferred.
• Familiarity with approved AI-enabled tools for Medicaid finance research, data analysis, financial modeling, proposal development, and quality review is preferred, with the ability to independently validate AI-assisted outputs for accuracy, regulatory relevance, and client confidentiality.
• Experience working with state Medicaid agencies, CMS, healthcare providers, managed care organizations, or other major healthcare stakeholders is preferred.
• Demonstrated leadership and people-management capabilities, including the ability to mentor team members, provide technical guidance, manage multiple workstreams, and develop the capabilities of direct reports.
• Strong project management skills, with a proven ability to take ownership of complex assignments, manage multiple projects simultaneously, meet deadlines, and produce client-ready deliverables with minimal supervision.
• Excellent oral and written communication skills, including the ability to explain complex healthcare policy, financial, and technical concepts clearly to senior executives, government officials, clients, and non-technical stakeholders.
• Strong analytical, quantitative, and problem-solving abilities, with quantitative program evaluation experience highly desirable.
• Ability to work effectively both independently and collaboratively in a fast-paced consulting environment, managing competing priorities while maintaining high standards of quality and client service.
• Strong understanding of healthcare policy and the ability to translate data, analytics, and regulatory developments into actionable strategies for healthcare management and financing decisions.

Benefits:

• Anticipated annual salary range of $127,600-$170,000 USD, with final compensation determined based on factors including experience, industry background, education, certifications, skills, and geographic market.
• Eligibility to participate in an annual Corporate Incentive Plan with potential variable compensation of up to 15% of annual salary.
• Medical, dental, and vision insurance for eligible employees and dependents.
• Short-term disability, long-term disability, and basic life insurance coverage.
• 401(k) retirement plan for eligible employees.
• Flexible Time Off allowing employees to take the time they need, subject to applicable policies and requirements.
• 16 paid holidays throughout the calendar year.
• Paid time off for qualifying medical leave.
• Up to 12 weeks of combined paid parental and bonding leave.
• Fully remote work environment.
• Opportunities for professional development and continued exposure to complex Medicaid policy, healthcare finance, and strategic consulting engagements.
• Access to learning and development opportunities through a collaborative, multidisciplinary consulting environment.