Medicaid and Children's Waiver Subject Matter Expert (SME)

The Medicaid and Children's Waiver Subject Matter Expert (SME) supports a state health agency client in the design, establishment, and operationalization of a new Medicaid Bureau. Operating within an integrated consulting team, this individual takes direction from client leadership to shape policy, operational frameworks, payment reform, and implementation deliverables.

The role carries a high degree of independent content ownership, with all work performed in coordination with the broader consulting team and project leadership to ensure unified delivery to the client.

Must be eligible to work in the United States. No sponsorships are available at this time.

Hours per week: 20-40 - no guarantee of 40hrs/week

Essential Duties:

Takes strategic direction from client leadership to help define the vision, operational approach, and overall goals for the new Medicaid Bureau

Facilitates structured discussions with state Medicaid agencies and key stakeholders to align deliverables with client expectations, policy requirements, and organizational objectives

Serves as a trusted thought partner to the client, translating complex state priorities and emerging concepts into actionable program plans

Collaborates with the broader consulting team, participating in strategic team planning, peer reviews, and quality assurance processes to deliver cohesive, firm-backed solutions

Acts as the primary author of critical workstream content, independently drafting and revising policy documents, operational guidance, and implementation frameworks from concept to client-ready completion

Maintains and drives detailed project workplans, working with team leadership to proactively identify, track, and mitigate project risks, dependencies, and outstanding policy questions

Develops strategic recommendations regarding Medicaid payment reform, reimbursement approaches, care delivery models, and alternative payment methodologies (APMs)

Translates complex regulatory and policy concepts into structured analyses, operational blueprints, and practical guidance documents for the Bureau's staff

Requirements

• Deep knowledge of state Medicaid policy, including managed care, fee-for-service delivery systems, waiver authorities, care management programs, and Medicaid program administration
• Expertise with home and community based services (HCBS) waiver programs, including eligibility, care management, provider requirements, and operational implementation considerations
• Ability to analyze complex policy, operational, financing, and programmatic considerations and translate findings into actionable recommendations
• Exceptional written and verbal communication skills, with the ability to produce polished, client-ready materials
• Education and Experience: Experience with New York State (NYS) Medicaid policy strongly preferred; equivalent experience with Medicaid policy in other states will be considered
• Demonstrated expertise with the New York State Children's Waiver, including HCBS services, eligibility, care management, provider requirements, and operational implementation
• Experience supporting programs serving children with medical complexity, medically fragile children, and other high-need pediatric populations
• Experience supporting the design, structuring, or operational establishment of state government units or bureaus, including program documentation, operational guidance, and implementation planning
• Significant experience developing Medicaid policies, operational guidance, and implementation plans, with a proven track record of drafting complex, client-facing deliverables
• Experience evaluating and developing Medicaid payment reform strategies, reimbursement approaches, care delivery models, alternative payment methodologies, or value-based payment (VBP) arrangements
• Physical Requirements & Environmental Conditions: An employee must meet these physical demands to successfully perform the essential functions of this job. Employee is regularly required to talk or hear, sit, stand, and utilize technology tools such as a laptop computer for extended periods of time. Specific vision abilities include close vision and the ability to adjust focus. This position requires the ability to occasionally lift up to 20 lbs. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Briljent is a solutions-based company. Solutions come from creative ideas; ideas come from being creative with differences. Briljent believes diversity and inclusion are critical to the success of the company. Employment at Briljent is based on merit and professional qualifications. We do not discriminate against any employee or applicant because of race, creed, color, religion, gender, sexual orientation, national origin, disability, age, veteran status, marital status or any other basis protected by federal, state or local law, regulation or ordinance.