Director, Medicaid Benefits and Health Program Group

Develops, monitors, and evaluates regulations, policies, procedures, and other guidelines for States in the design and implementation of their Medicaid programs in key program areas and provides technical assistance to support states. Develops and monitors 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. Establishes, implements, and oversight for the Medicaid program policy for the Health Homes, and Program for All Inclusive Care for the Elderly (PACE) programs. Reviews, and approves, benefits/coverage and State Plan Amendments, and 1915(c) waivers. Administers and monitors systems transformation grants, including Money Follows the Person. Assists the States in the design and implementation of their community-based long-term care support systems. Establishes policy regarding program monitoring, performance management, qua