Nicole Kaufman provides strategic consulting and thought leadership on public health programs and the private insurance market. She has over a decade of experience with Medicaid policy, operations, and regulations at the federal and state level.
With a comprehensive understanding of federal Medicaid regulations and policy and Ms. Kaufman's recent experience as a trusted advisor to several states on Medicaid managed care operational, financial, and policy matters, she is focused on supporting payers and providers with timely information and analysis to inform strategic decisions and thrive within the dynamic health care marketplace.
Prior to joining FTI Consulting, Ms. Kaufman was a Principal at Mercer’s Government practice. In this role, she drafted managed care contracts to ensure federal compliance and consistency with states’ programmatic design; developed and successfully negotiated federal approval of directed payments impacting the spectrum of health care providers; disseminated federal guidance with actionable analysis; presented federal authority options to best meet states’ objectives; and supported states throughout the managed care procurement process, from design through readiness review. She also worked closely with Mercer’s actuaries to evaluate rate setting approaches and support federal approval of Medicaid rate certifications.
Prior to consulting, Ms. Kaufman was the technical director for Medicaid managed care policy at the Centers for Medicare and Medicaid Services (CMS). She was the primary author of the Medicaid provisions within the Medicaid and CHIP Managed Care Proposed Rule (2015) and Final Rule (2016) that modernized the federal regulatory framework through alignment with Medicare Advantage and the private market, as appropriate. Her initial position at CMS involved negotiation, approval, and monitoring of several complex section 1115 demonstrations that involved coverage and benefit expansions, premium assistance, and delivery system reform incentive payment (DSRIP) programs.
Ms. Kaufman holds a bachelor’s degree in history and political science from the University of Illinois, her Juris Doctor from Southern Illinois University School of Law, and her Master of Laws in health law from the Saint Louis University School of Law.