Lead Consultant – Medicaid

We are seeking a Lead Consultant – Medicaid to lead advisory engagements with state and local Medicaid agencies. This role focuses on management consulting services and serves as a trusted advisor to Medicaid clients or potential clients, leads consultative discussions that shape client strategy, and is accountable for converting those discussions into successful consulting engagements. This role also plays a key role in responding to consulting focused Medicaid procurements and collaborates closely with internal delivery, business development (BD), sales, and capture teams. This role requires current Medicaid Consulting experience as a project leader. 
 

Strategic Operational and Policy Support

The Lead Consultant - Medicaid will provide strategic operational and policy support to states. Consulting services may include:
 

• Policy & Legislative Analysis – Evaluate and assess the impact of and compliance with state and federal legislation on program operations and strategy.
• Program Design & Reform – Assist the Medicaid agency in creating and implementing Medicaid reform initiatives, including Section 1115 demonstrations.
• Financial Consulting – Assist the state with financial reviews including but not limited to review of managed care and provider cost reporting.
• Program Operations – Advise states on improvements in eligibility, enrollment, and customer service systems.
• Quality Performance Analysis – Assess and improve care quality, including care delivered through managed care delivery systems.

Job Duties and Responsibilities:

The Lead Consultant provides strategic operational, policy, and program advisory support to public‑sector clients. Consulting services may include:

• Policy & Regulatory Analysis – Evaluate and assess the operational, financial, and strategic impact of federal and state policy, regulatory, and legislative changes.
• Program Design & Reform – Support clients in the design, modernization, and implementation of complex public programs and reform initiatives.
• Financial & Performance Consulting – Conduct financial and operational reviews, including funding models, cost reporting, and program sustainability analyses.
• Program Operations & Transformation – Advise clients on improving program administration, service delivery, eligibility/enrollment processes, and customer experience.
• Quality & Outcomes Analysis – Assess and enhance program performance, quality outcomes, and accountability frameworks across delivery models.

Client Advisory & Thought Partnership

• Serve as a senior advisor to executive‑level leaders within public‑sector organizations on strategy, governance, oversight, and operational improvement.
• Apply deep knowledge of public policy, regulatory frameworks, and government operations to guide client initiatives.
• Advise clients on business process redesign, program readiness, risk management, and performance improvement.
• Build long‑term, trusted relationships with senior government leaders and stakeholders.
• Deliver actionable, credible recommendations grounded in policy, operational, and financial expertise.

Consulting Engagement Leadership

• Lead consulting engagements from initial advisory discussions through scoping, execution, and delivery.
• Develop workplans, governance structures, and objective deliverables aligned to client needs.
• Provide senior oversight to ensure delivery quality, manage risk, and maintain high client satisfaction.
• Identify, recruit, and oversee consulting team members to support engagements.
• Partner with internal stakeholders to strengthen go‑to‑market strategies and expand advisory offerings.
• Support business development efforts, including proposal development, win strategies, and executive presentations.

Cross‑Functional Collaboration

• Collaborate closely with internal delivery teams supporting client operations and services.
• Coordinate across consulting, delivery, business development, and executive leadership to present an integrated advisory presence.
• Contribute to market‑facing thought leadership that reinforces organizational credibility and expertise.

Job-Specific Essential Duties and Responsibilities:

Client Advisory & Thought Partnership

• Lead executive-level conversations with state and local Medicaid agencies on program strategy, operational improvement, governance, and oversight.
• Apply deep knowledge of federal Medicaid policies and regulations to support and guide client initiatives.
• Advise clients on topics including business process redesign, program readiness, risk management, and performance improvement.
• Build long-term, trusted relationships with Medicaid directors, deputy directors, program leaders, and other state and local staff.
• Leverage deep expertise in Medicaid policy, federal regulations, and state operations to deliver actionable, credible recommendations.

Consulting Engagement Leadership

• Manage consulting engagements that result from advisory discussions, from initial scoping through delivery and client outcomes.
• Develop consulting workplans, governance structures, and deliverables that are objective, independent, and aligned to client needs.
• Provide senior oversight to ensure delivery quality, manage risk, and maintain strong client satisfaction.
• Recruit team members to support Medicaid consulting opportunities. 
• Partner with internal stakeholders on joint Medicaid consulting and operational opportunities to strengthen go-to-market strategies.
• Partner with Business Development, Sales, and Capture teams to shape win strategies, value propositions, and client messaging.
• Participate in proposal reviews, oral presentations, and executive briefings.

Cross-Functional Collaboration

• Work closely with internal teams already delivering Medicaid enrollment, eligibility, and operational services to state clients.
• Collaborate across consulting, delivery, BD, capture, and executive leadership to present a coordinated and credible Medicaid advisory presence.
• Contribute to market-facing thought leadership that reinforces the organization’s position as a trusted Medicaid consulting partner.

Minimum Requirements:

• Bachelor's degree in relevant field of study and 7+ years of relevant professional experience required, or equivalent combination of education and experience.

Job-Specific Minimum Requirements:

• Bachelor’s degree required; advanced degree in public policy, public administration, healthcare administration, or a related field preferred.
• 7+ years of hands-on experience working in senior-level positions for state Medicaid programs and/or consulting to state Medicaid programs.
• Demonstrated experience leading or advising on Medicaid consulting engagements.
• Proven ability to engage credibly with senior Medicaid executives and agency leadership.
• Solid understanding of federal and state law and rules governing the Medicaid program as well as Medicaid financing.
• Experience supporting or leading responses to consulting-focused Medicaid procurements.
• Strong executive communication, facilitation, and relationship-building skills.

Preferred Skills and Qualifications:

• Experience in organizations that provide both consulting and operational Medicaid services, with an understanding of independence and role boundaries.
• Experience with MITA, CMS requirements, and certification frameworks (MECT, MEET, SMC).