Shelly Fox Email and Phone Number

Provide in-depth research and analysis of Medicaid and Medicare policy issues, including: Serve as Subject Matter Expert (SME) on Medicaid Managed Care, HCBS waiver services, SSI Medicaid, PACE and Dual Eligible Special Needs Plans (D-SNPs).Conduct time-sensitive analyses of complex policy and regulatory topics for DMS leadership and other Department of Health Services partners upon request;Drafting, editing and analysis of statewide Medicaid MCO, PACE, and D-SNP contracts;Conduct annual reviews of MCO and HMO member documents such as Grievance & Appeals policies, marketing and communication guides, member handbooks, member correspondence, etc. to ensure compliance with federal Medicaid and Medicare requirements;Prepare policy documents such as white papers, briefing memorandums, options papers, etc, for senior leadership;Draft and review proposed legislative language and emergency orders;Serve as Managed Care section’s internal Subject Matter Expert (SME) on issues related to the federal response to Covid-19, including 1915(c) waiver Appendix K flexibilities and Medicaid eligibility/enrollment requirements under the federal Public Health Emergency (PHE). Duties included intensive outreach to and coordination with HMO industry partners and community organizations. Required strong subject matter expertise in Medicaid managed care administration for high-need communities and the effects of social determinants of health on consumer awareness and outreach needs.