Medicare/Medicaid Dual-Eligible Program Architect – Rural & Frontier Health

This is a fully remote position, open to applicants in Washington.

📋 Description

• Assist the State of Montana in the development of a pilot initiative for dual-eligible members.

• Evaluate the needs of the population.

• Analyze the subpopulations of dual-eligible individuals with the highest needs and identify the key factors contributing to adverse outcomes and elevated costs.

• Create Integrated Care Models.

• Assess models that are appropriate for rural dual-eligible populations and evaluate their feasibility for Montana.

• Formulate Recommendations for Payment Models.

• Design or assess payment models that include rural-specific adjustments.

• Address Challenges in Care Delivery and Workforce.

• Suggest strategies for care delivery that consider workforce shortages.

• Establish Governance and Accountability Structures.

• Propose governance and contracting frameworks that promote shared accountability among plans, providers, and regional entities.

⛳️ Requirements

• Minimum of 5 years of experience in Medicaid/Medicare program design, integrated care delivery, managed care policy, or a related field.

• In-depth understanding of dual-eligible program frameworks, including Medicare-Medicaid alignment initiatives, D-SNPs, PACE, and similar models.

• Proven experience with rural or frontier health systems, including the workforce, infrastructure, and access challenges they face.

• Practical knowledge of LTSS, HCBS waivers, and the populations they serve.

• Experience collaborating with state Medicaid agencies, CMS, or managed care organizations.

• Excellent written communication skills, capable of simplifying complex policy alternatives into actionable memos for senior state officials.

🏝️ Benefits

• Competitive compensation aligned with the outcomes you achieve and the hours and weeks you dedicate to leading project work.

• Bonuses for acquiring new clients.