Associate Director​/Director, Medicaid Entitlement & Coverage Strategy

Associate Director/Director, Medicaid Entitlement & Coverage Strategy

Location:

Name Linked Remote - US

The Associate Director/Director of Medicaid Entitlement & Coverage Strategy leads the organization's strategic response to federal Medicaid changes. This role will be responsible for positioning GRT to become a Medicaid Qualified Entity (QE) in all of its operating states where eligible, implementing a medical frailty documentation protocol, deploying SOAR (SSI/SSDI Outreach, Access, and Recovery) training across the organization, building internal infrastructure to directly enroll eligible members in Medicaid and support them through redetermination, and evaluating and reporting program outcomes to leadership.

This is a cross-functional role that requires exceptional organizational and communication skills, experience navigating state government systems, and the ability to drive complex multi-state initiatives independently and with urgency. While the initial focus is standing up GRT's Medicaid entitlement and coverage strategy and infrastructure across all operating states, the ongoing scope and responsibilities will evolve based on program needs, organizational growth, and the shifting federal and state Medicaid landscape.

Salary Range for Associate Director level: $72k-$118k. Salary Range for Director level: $95k-$130k

Fully Remote work (not available to residents of AK, AR, CA, HI, , MD, NE, SD, UT, WY).

• Lead GRT's application process to become a Medicaid QE in all operating states where eligible, including working with GRT's legal counsel to submit MOUs to each state Medicaid agency, coordinating staff training, and ensuring ongoing compliance with state QE requirements
• Oversee the implementation of SOAR training for designated staff across all operating states, ensuring trained staff are registered and equipped to assist members with SSDI and SSI applications; establish pre-release SSDI/SSI application pipelines through GRT's corrections partnerships where applicable
• In partnership with GRT's medical and product leadership, develop, implement, and maintain a standardized medical frailty documentation protocol, ensuring the protocol is embedded into intake and annual review workflows across all Medicaid expansion states
• Lead the development and implementation of systems, workflows, and member support strategies designed to help eligible members meet state Medicaid requirements. This includes identifying at-risk members, tracking compliance milestones, facilitating documentation of qualifying activities and exemptions, working with field teams to coordinate referrals to community resources, and working with operational teams to reduce avoidable coverage losses.
• Support GRT's Government Affairs team by assisting with tracking federal and state legislation, regulations, and guidance related to Medicaid work requirements, presumptive eligibility, and One Big Beautiful Bill Act implementation across all operating states.
• Collaborate with the Government Affairs Team in translating policy developments into actionable operational updates for GRT's teams in a timely manner.
• Support GRT's Government Affairs team in interacting with state Medicaid agencies and other stakeholders on matters related to QE enrollment, redetermination processes, and member coverage protection strategies.
• In partnership with the Product Team, design and maintain an internal tracking system to identify members at risk of losing Medicaid coverage due to redetermination, work requirements, documentation barriers or other eligibility challenges; members presenting without Medicaid coverage, and members who may qualify for SSDI/SSI.
• In partnership with the Learning and Development Team, develop and deliver training and educational resources for entitlement staff, counselors, and clinical providers on QE processes, medical frailty documentation, and SSDI/SSI application assistance.
• Develop and maintain a comprehensive evaluation framework that measures coverage retention, redetermination outcomes, work requirement compliance and exemption utilization, SSDI/SSI enrollment outcomes, and reasons for Medicaid…