Medicaid Procurement & RFP Strategy Consultant

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Summary

This Medicaid Procurement & RFP Strategy Consultant is a nationally recognized Medicaid executive with deep, hands-on experience leading Medicaid strategy, operations, financial performance, and organizational design within large integrated health systems and managed care organizations. Most recently serving as Executive Director of Medicaid for Kaiser Permanente, she led multi-state Medicaid strategy and P&L oversight across numerous states, including California. 

 

This Medicaid Procurement & RFP Strategy Consultant brings extensive expertise in Medicaid managed care, MLTSS, TANF, ABD, CHIP, and D-SNP programs — including procurement strategy, contract execution, regulatory compliance, integrated delivery model alignment, and financial performance management. She has successfully reorganized and consolidated Medicaid operations into unified business units, built governance and financial oversight structures, stood up new state market entries, and driven measurable financial turnarounds. This Medicaid Procurement & RFP Strategy Consultant understands how integrated health systems must align clinical operations, actuarial, finance, network management, care delivery, compliance, and community engagement functions to meet contractual requirements while achieving operational efficiency and financial sustainability. 

Highlights

• Medicaid Executive Leadership
• Multi-State Medicaid Strategy & P&L Ownership
• Managed Care Operations (TANF, ABD, CHIP, MLTSS, D-SNP)
• Health Plan Financial Performance & Turnaround Leadership
• Integrated Health System Medicaid Alignment (Clinical, Finance, Network, Compliance)
• Medicaid Procurement, RFP Strategy & Market Entry

Relevant Accomplishments

 National Medicaid Executive – Integrated Health System Leadership – As Executive Director of Medicaid at Kaiser Permanente, led Medicaid strategy, operations, and financial oversight across multiple states, including California. Oversaw TANF, CHIP, ABD, MLTSS, and D-SNP programs with $1.5B P&L responsibility. Reduced Medicaid losses by 60% over four years and moved two markets to profitability. 

 

• Organizational Reorganization & Governance Infrastructure– Reorganized and consolidated multi-state Medicaid staff into a single unified business unit. Established corporate Medicaid governance structures and financial oversight processes, aligning health plan, actuarial, operations, and finance teams to improve accountability and efficiency. 

 

• Medicaid Procurement & Contract Strategy Leadership– Built Kaiser Permanente’s first dedicated Medicaid RFP and grant department. Successfully led high-scoring Medicaid procurements across multiple states. Deep understanding of Medicaid contract requirements, rate setting, regulatory oversight, and state insurance licensure processes. 

 

• Integrated Care Model Design & Resource Alignment– Developed new Medicaid business models integrating Kaiser’s delivery system with external safety net providers to create high-performing care delivery systems. Led strategic initiatives including population health management and value-based care programs tailored to Medicaid populations. 

 

• D-SNP & MLTSS Expertise– Served as Medicaid operational executive leader for D-SNP products across markets. Extensive experience designing and implementing MLTSS and dual-eligible models in complex regulatory environments. 

 

• Managed Care Start-Up & Growth Leadership– Cofounder and Chief Development Officer of Senior Whole Health, a multi-state, venture-backed managed care organization serving dual-eligible populations. Led Series A and B venture financings, built operational and financial infrastructure (claims, enrollment, capitation reconciliation, actuarial), and drove the organization to profitability. 

 Network Management & LTSS Infrastructure Development – As Interim Network Management Executive at Boston Medical Center Health Plan (now Mass General Brigham Health Plan), re-engineered provider relations, contracting, credentialing, and operations. Built LTSS provider network infrastructure to support FIDE-SNP implementation. 

 

• Medicaid Care Management Innovation– CEO of Core Health, a Medicaid-focused intensive case management organization serving complex ABD, MLTSS, and dual-eligible populations. Grew company to $10M revenue and implemented innovative care management programs aligned to state Medicaid objectives. 

 

• Medicaid Market & Policy Advisory Leadership– Principal at Health Management Associates, advising on Medicaid MCO financial performance, DSNP start-ups, capitation trends, and procurement strategy. 

 

• Medicaid Consulting & Recent Engagements

• Led AI in Medicaid procurement initiatives: directed a cross-functional team to define high-value use cases and assess vendor solutions. 

• Partnered with provider-led organizations on Medicare Advantage/D-SNP start-ups, including business plan development and early operations planning. 

• Conducted private equity diligence, evaluating HR1 and recent Medicaid capitation trends for a firm considering investment in a publicly-traded Medicaid/government programs health plan. 

• Served as account lead for HCSC’s multi-state Medicaid business, overseeing operational and financial performance. 

• Led multiple webinars on Medicaid Managed Care shifts, covering financial pressures, federal policy, and MCO implications. 

Roles

• Independent Health Management Consultant 

• Executive Director, Medicaid, Kaiser Permanente 

• Interim Network Management Executive, Boston Medical Center Health Plan 

• Chief Executive Officer, Core Health, LLC 

• Chief Development Officer / Vice President Finance & Operations, Senior Whole Health 

• Business Unit Leader, Provider Operations, Blue Cross Blue Shield of Massachusetts 

• Associate Director, Operations & Finance, Neighborhood Health Plan (now Mass General Brigham Health Plan

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