Executive Consultant/Medicaid, Medi-Cal Systems Integrator

Description

Executive Consultant/Medicaid, Medi-Cal Systems Integrator

KAI Partners, Inc. (KAIP) is currently seeking a Senior Consultant – Medicaid/Medi-Cal Systems Integrators provide executive advisory services and delivery leadership for large-scale public-sector healthcare and human services technology transformation initiatives. This role supports state agencies and enterprise programs through strategic planning, governance design, organizational assessment, operational improvement, systems modernization, service delivery oversight, and multi-vendor coordination.

The ideal candidate brings experience advising executive leadership, managing complex stakeholder environments, establishing governance and PMO structures, overseeing vendor and contract performance, and leading organizational change associated with large-scale technology implementations. Candidates should possess a strong understanding of Medicaid/Medi-Cal programs and broader public-sector healthcare and human services operations, with the ability to translate policy, operational, business, and technical requirements into successful implementation and transformation outcomes.

Responsibilities  

• Serve as a senior consultant supporting Medicaid/Medi-Cal, or state healthcare program initiatives.
• Provide systems and process integration support across business, technical, operational, policy, vendor, and program teams.
• Translate complex Medicaid/Medi-Cal program requirements, client priorities, and stakeholder needs into actionable work plans, process flows, decision materials, and implementation recommendations.
• Support data, integration, testing, functional advisory, project coordination, and implementation of readiness activities, as assigned.
• Apply Medicare and Medicare Advantage knowledge to support pharmacy benefit coordination, claims routing, payer responsibility analysis, and operational problem-solving.
• Facilitate collaboration across multiple stakeholder groups, including state program staff, IT teams, vendors, policy teams, operations teams, executive leadership, and external partners.
• Identify operational gaps, system dependencies, process risks, and implementation barriers; recommend practical mitigation strategies.
• Support requirements gathering, process mapping, workflow analysis, stakeholder interviews, meeting facilitation, decision tracking, and issue resolution.
• Develop clear, concise, executive-ready materials, including briefing documents, status updates, decision logs, risk summaries, process documentation, and implementation plans.
• Assist with governance, escalation, and coordination activities to ensure alignment across workstreams and timely resolution of issues.
• Monitor project milestones, dependencies, risks, and stakeholder commitments to support delivery of quality and accountability.
• Apply knowledge of Medicaid/Medi-Cal policy, operations, claims, eligibility, managed care, benefits, pharmacy, fiscal, or related healthcare program areas, depending on project assignment.
• Support compliance, audit readiness, documentation quality, and alignment with applicable state and federal healthcare requirements.
• Demonstrate high emotional intelligence when navigating sensitive conversations, competing priorities, stakeholder conflict, and organizational change.
• Build trust with clients by communicating clearly, following through commitments, and maintaining professionalism in high-pressure environments.
• Serve as a trusted advisor to executive leadership, providing strategic guidance, decision support, risk assessments, and recommendations related to large-scale public-sector technology transformation initiatives.
• Lead or support the design, implementation, and continuous improvement of governance frameworks, PMO structures, executive steering committees, decision-making processes, and performance management practices.
• Conduct organizational assessments to evaluate operating models, business processes, workforce readiness, governance maturity, and organizational effectiveness; develop recommendations for operational improvement and transformation.
• Provide oversight of service delivery performance, ensuring accountability for project outcomes, contractual obligations, service-level expectations, quality standards, and stakeholder commitments.
• Manage complex vendor ecosystems consisting of systems integrators, technology vendors, business partners, state agencies, and external stakeholders; facilitate alignment, issue resolution, and coordinated delivery across organizations.
• Lead transition planning, organizational readiness, change management, stakeholder adoption, communications, training coordination, and post-implementation stabilization activities.
• Support enterprise modernization efforts involving healthcare, human services, eligibility, benefits administration, program operations, fiscal systems, data platforms, and related public-sector technology environments.
• Monitor vendor performance, contractual deliverables, implementation commitments, and governance requirements; identify risks and recommend corrective actions to maintain delivery success.
• Develop and present executive-level governance materials, strategic roadmaps, organizational assessments, operational improvement recommendations, and transformation status reporting for senior agency leadership and executive stakeholders.
• Provide thought partnership to KAIP leadership on client needs, role clarity, delivery risks, and opportunities to strengthen service delivery.
• Other duties, as assigned. 

Skills and Qualifications

• Strong knowledge of Medicaid, Medi-Cal, and public-sector healthcare or human services programs and operations.
• Ability to serve as a liaison across business, technical, operational, and policy domains, translating complex information into clear recommendations, implementation plans, and business solutions.
• Strong stakeholder engagement, facilitation, and consensus-building skills, with experience working across multi-vendor, multi-division, matrixed organizations, including government agencies, vendors, systems integrators, program leadership, and technical teams.
• Excellent written and verbal communication skills, including executive-level reporting, client-facing materials, meeting facilitation, decision documentation, and presentation of complex concepts to diverse audiences.
• Strong analytical, problem-solving, and risk management capabilities, including identifying dependencies, process gaps, implementation impacts, and developing mitigation strategies.
• Familiarity with California state project governance and oversight frameworks of procurement, and project management processes.
• High emotional intelligence, professionalism, diplomacy, and sound judgment, with the ability to influence without authority, navigate ambiguity, and operate effectively in high-visibility or politically sensitive environments.
• Ability to work independently, manage multiple priorities in a fast-paced consulting environment, and maintain alignment with leadership, client expectations, governance standards, and quality requirements.
• Proficiency with Microsoft Office, SharePoint, Teams, Visio, Jira, Smartsheet, Power BI, and similar collaboration, reporting, and project management tools.
• Experience with Medi-Cal systems and operations, including MMIS, claims processing, eligibility, managed care, pharmacy benefits, provider operations, data exchange, and fiscal systems.
• Demonstrated experience providing executive advisory services to agency executives, steering committees, and senior leadership.
• Experience leading large-scale public-sector technology transformation and modernization initiatives.
• Expertise in governance framework design, PMO establishment, portfolio oversight, and executive decision support.
• Experience managing large multi-vendor ecosystems, including systems integrators, technology vendors, implementation partners, and government stakeholders.
• Strong service delivery management skills, including contract accountability, performance monitoring, and delivery oversight.
• Experience conducting organizational assessments, operating model reviews, workforce readiness evaluations, and operational improvement initiatives.
• Expertise in organizational change management, transition planning, stakeholder adoption, and implementation readiness.
• Broad knowledge of public-sector healthcare and human services programs, including Medicaid/Medi-Cal, eligibility systems, benefits administration, and related state programs.

Work/Education Experience  

• Bachelor’s degree in Public Administration, Business Administration, Healthcare Administration, Information Systems, Public Health, Social Services, or related fields. (Required)
• Master’s degree, PMP, Prosci, CSM, Lean Six Sigma, ITIL, or related certification. (Preferred)
• 10+ years of experience in public-sector consulting, healthcare, human services, technology transformation, organizational improvement, program management, or systems modernization initiatives.
• 5+ years providing executive advisory, governance, PMO, service delivery, or large-scale transformation leadership for state government, healthcare, or human services organizations.
• Demonstrated experience working within complex multi-vendor environments and overseeing vendor performance, contractual obligations, and service delivery outcomes.
• Experience supporting enterprise-scale technology implementations, modernization initiatives, organizational change efforts, and operational transformation programs.

Compensation Range: $165,000 - $189,000

The salary range for this role may vary depending on the specific geographic location where this position is ultimately filled. Several factors, including but not limited to a candidate's experience, education, skills, and certifications, pay equity, and organizational needs, are considered when determining the posted salary range. In addition, eligible roles also qualify for a comprehensive benefits package. 

Must be able to provide proof of education for all mandatory qualifications; all references will be verified. 

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, or national origin. 

KAI Partners

KAI Partners, Inc. is a Northern California-based small business that offers world-class management consulting and technology services to public and private sector clients on a variety of large-scale projects. The KAI Partners team has over 100 years of combined executive-level experience in information system design, development, implementation, and testing. Our clients benefit from our proven program management, project management, and oversight, program portfolio management, Agile services, organizational change management, training, enterprise architecture, managed IT service, and IT security support.

http://www.kaipartners.com/