Position Summary

The Senior Director, Medicaid & Payer Reimbursement Policy, will develop and direct strategies, analyses, proposals, and responses to Medicaid coverage and hospital/health system payment issues. In collaboration with other WHA staff, this position will lead WHA’s analysis and policy development efforts on Medicaid coverage, reimbursement and managed care organization accountability.  

Job Responsibilities

• Monitor Medicaid program activity, interact with key DHS staff and other state agencies, and help create a comprehensive Medicaid strategy that sustains access to care for Wisconsin’s Medicaid population and supports care provided by hospitals and health systems to all patients, including Medicaid enrollees.

• Perform liaison role with DHS through many avenues including the WHA Medicaid Advisory Group and communicate key Medicaid issues to membership through various means (Valued Voice, councils or workgroups, email, white papers, webinars, etc.)

• Review and develop policy responses to federal and state Medicaid regulations as well as the Wisconsin Medicaid managed care contract.

• Serve as WHA’s liaison to the Office of Commissioner of Insurance and lead policy staff on legislation and regulations affecting commercial payer practices. 

• Lead WHA’s public policy work on health care provider, insurer and third-party administrator price transparency laws and regulations. Collaborate with the WHA Chief Operating Officer/Senior Vice President Finance on member-related communications and initiatives related to transparency. 

• Collaborate with the WHA Vice President, Federal & State affairs on Medicare payment regulations 

• Serve as WHA’s liaison to the state’s Worker’s Compensation Advisory Council. 

• Monitor the Group Insurance Board at the Department of State Employee Trust Funds.

Internal / External Contacts

The Senior Director has daily contact with WHA staff to coordinate development of WHA public policy. The Senior Director has frequent contact with WHA members, state officials and staff, and other advocacy organizations.

Knowledge & Experience

A Bachelor’s degree is required; a Master’s degree is preferred in an area related to public policy, healthcare, political science, economics or business. The Senior Director must have a working knowledge of hospital reimbursement methodologies and related issues. Ideal candidates will have a strong working relationship and/or understanding of the state Medicaid program and the ability to translate the diverse views and needs of the WHA membership. Excellent writing and public speaking skills are essential competencies for this position. Microsoft Office 365 competency, including Word, PowerPoint and Teams applications, is required. 

Scope & Challenges

A major challenge in this position will be keeping track of the numerous developments occurring related to hospital reimbursement and evaluating the impact of those developments on the WHA membership. 

Another major challenge for this position will be effectively prioritizing his or her workload given the important issues that will compete for time. To be successful, the person in this position will need to evaluate issues quickly in a high-paced environment. The Senior Director will need to present the results of analyses, proposals, responses, and strategies concisely and in a way that is appropriate to the audience, which can range from the people who are very familiar with technical details to people who need to know the general policy direction.

Please share your salary expectations. Salary will be commensurate with experience.

Working Conditions

• This position works in a professional business environment.
• This is an in office position with the potential for hybrid work flexibility in the future.
• The ability to sit/stand for periods of 1 – 2 hours.
• The ability to manage multiple tasks and deadlines.

Wisconsin Hospital Association is an equal opportunity employer and does not discriminate based on race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, mental or physical disability unrelated to ability to do the job, or any other characteristic protected by law.