Director, State Demonstration Group

Centers for Medicare & Medicaid ServicesWoodlawn, Maryland, Kansas City, Missouriusajobspublished 10/15/2026
Must-have:SeniorLead

This position is located in the Center for Medicaid and CHIP Services (CMCS), State Demonstrations Group, Centers for Medicare & Medicaid Services (CMS). As the Director of the State Demonstrations Group, you will provide executive leadership and national policy direction for Medicaid Section 1115 demonstrations, including their design, approval, financing, including budget neutrality, implementation, oversight, and evaluation.

Major duties

  • Provides executive leadership and national strategic direction for Section 1115 demonstrations, translating Administration, HHS, and CMS priorities into national policies, strategies, and implementation approaches.
  • Establishes and implements national policies, standards, and procedures for Section 1115 design, review, approval, financing, budget neutrality, implementation, monitoring, renewal, and evaluation.
  • Leads review, negotiation, and approval of Section 1115 demonstrations and ensures fiscal integrity and budget neutrality while resolving complex legal, financing, actuarial, and programmatic issues.
  • Leads implementation of major Medicaid legislative mandates, translating statutory requirements into national policies and operational strategies and coordinating execution across CMS, HHS, States, and Federal partners.
  • Advises senior State Medicaid officials and leads Federal coordination with OMB, OGC, the CMS Chief Actuary, HHS, and other agencies to resolve complex Section 1115 policy, fiscal, financing, budget neutrality and implementation issues.
  • Directs governance, monitoring, evaluation, and continuous improvement for the Section 1115 portfolio, leveraging technology, data, transparency, monitoring and evaluation findings to strengthen accountability and inform national policy.
  • Advises senior CMS and HHS leaders and represents CMS with the Administration, Congress, States, and Federal partners while directing workforce and resources and ensuring the performance and integrity of the Section 1115 enterprise.
  • Identifies emerging Medicaid trends, systemic risks, and policy opportunities and directs strategic and corrective actions to achieve national program objectives, ensure Federal compliance, and safeguard Medicaid resources.

Qualifications

Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution. Candidates will not be hired based on their race, sex, color, religion, or national origin. To meet the minimum qualification requirements for this position, you must show that you possess the Executive Core Qualifications (ECQ) and Technical Qualifications (TQ) related to this position within your resume - NOT TO EXCEED 2 PAGES. Resumes over the 2-page limit, will not be reviewed beyond page 2 or may be disqualified. Your resume should include examples of experience, education, and accomplishments applicable to the qualification(s). If your resume does not reflect demonstrated evidence of these qualifications, you may not receive consideration for the position. There is NO requirement to prepare a narrative statement specifically addressing the Executive Core Qualifications (ECQs) or the Technical Qualifications (TQs).

TECHNICAL QUALIFICATIONS (TQs): Your resume should demonstrate accomplishments that would satisfy the technical qualifications.

TQ 1: Demonstrated executive-level experience leading national Section 1115 Medicaid demonstration policy, including budget neutrality methodologies, Medicaid and State financing, Federal financial participation, and implementation of major legislative mandates. Experience leading and managing a large and/or highly complex, multidisciplinary workforce, including through subordinate supervisors; setting strategic direction; aligning organizational structures, workforce capacity, and financial and operational resources with mission priorities; and maintaining direct accountability for organizational performance, workforce management, and fiscal outcomes. Experience resolving complex, high-profile, politically sensitive, or precedent-setting issues with significant national policy and fiscal implications; advising senior officials; and negotiating with Federal and State leaders and stakeholders to resolve programmatic, regulatory, financial, and operational challenges. Demonstrated ability to lead through organizational change, competing priorities, and resource constraints while developing leadership capacity, managing risk, and ensuring successful execution of high-visibility program objectives.

TQ 2: Demonstrated tenured, executive-level expertise interpreting and applying complex and evolving statutory, regulatory, and policy frameworks to make authoritative, precedent-setting determinations on Section 1115 demonstrations, including budget neutrality, Medicaid financing, Federal financial participation, and program design. Experience resolving novel or ambiguous legal, policy, fiscal, and operational issues; establishing defensible policy interpretations; translating program priorities and major legislative mandates into implementable initiatives; and advising senior leadership, State Medicaid officials, Federal partners, and Congress on matters of significant consequence and nationwide impact. Demonstrated ability to integrate complex policy, fiscal, operational, and risk considerations into executive decision-making and coordinate across multidisciplinary teams and intergovernmental stakeholders to achieve national program objectives.

EXECUTIVE CORE QUALIFICATIONS (ECQs): In addition to the Technical Qualification Requirements listed above, all new entrants into the Senior Executive Service (SES) under a career appointment will be assessed for executive competency against the following five mandatory ECQs. If your 2-page resume does not reflect demonstrated evidence of the ECQs and TQs, you may not receive further consideration for the position. There are five ECQs:

ECQ 1: Commitment to the Rule of Law and the Principles of the American Founding - This core qualification requires a demonstrated knowledge of the American system of government, commitment to uphold the Constitution and the rule of law, and commitment to serve the American people.

ECQ 2: Driving Efficiency - This core qualification involves the demonstrated ability to strategically and efficiently manage resources, budget effectively, cut wasteful spending, and pursue efficiency through process and technological upgrades.

ECQ 3: Merit and Competence - This core qualification involves the demonstrated knowledge, ability and technical competence to effectively and reliably produce work that is of exceptional quality.

ECQ 4: Leading People - This core qualification involves the demonstrated ability to lead and inspire a group toward meeting the organization's vision, mission, and goals, and to drive a high-performance, high-accountability culture. This includes, when necessary, the ability to lead people through change and to hold individuals accountable.

ECQ 5: Achieving Results - This core qualification involves the demonstrated ability to achieve both individual and organizational results, and to align results to stated goals from superiors.

Note: If you are a member of the SES or have been certified through successful participation in an OPM approved SES Candidate Development Program (SESCDP), or have SES reinstatement eligibility, you do not need to respond to the ECQs. Instead, you should attach proof (e.g., SF-50, Certification by OPM's SES Qualifications Review Board (QRB)) of your eligibility for noncompetitive appointment to the SES.