Director, Medicaid Benefits and Health Program Group

Job Title

The job duties include:

• Developing, monitoring, and evaluating regulations, policies, procedures, and other guidelines for States in the design and implementation of their Medicaid programs in key program areas and providing technical assistance to support states.
• Developing and monitoring Medicaid pharmacy policy, including the Medicaid Drug Rebate Program, classification of drugs, Federal Upper Limits, drug utilization review, prior authorization, Federal offsets/recapture, and preferred drug lists.
• Establishing, implementing, and overseeing the Medicaid program policy for the Health Homes, and Program for All Inclusive Care for the Elderly (PACE) programs.
• Reviewing and approving benefits/coverage and State Plan Amendments, and 1915(c) waivers.
• Administering and monitoring systems transformation grants, including Money Follows the Person. Assisting the States in the design and implementation of their community-based long-term care support systems.
• Establishing policy regarding program monitoring, performance management, quality improvement, and consumer protections for programs and services administered by MBHPG.
• Leading national Medicaid benefits and coverage policy, including behavioral health, long-term supports, home health, and clinical care.
• Providing national leadership on the development and management of Medicaid program policy related to benefits and coverage. To include mental health, substance use disorder services, long-term supports, home health, and clinical/facility care, etc.