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Leading During Transition is an Exercise in Mutual Support

There is a lot of change afoot.  Elections have ushered in new leadership across states – from the governor’s mansion to the state house and even some Medicaid agencies.  There is a natural year end cycle that can drive leadership changes.

During my time as interim executive director at NAMD, I’ve had the pleasure to work with a dream team of highly intelligent, competent, kind human beings. It’s been a joy. And it’s also been a genuine learning experience for me. While the lessons have been myriad, possibly the most important one is the value of thinking of teams not as a pyramid, but as a circle.

A coach in my life that I value, often says, “hands on your back” when the effort we are making together is particularly challenging. We are supporting each other in a circle of teamwork, hands on each other’s backs providing support as we climb the hill together. I think of this in this moment because my upcoming transition in the association mirrors the transitions happening across every Medicaid program in the country in one way or another.

January is the time of leadership transitions happening at the highest levels within state government. Nine states have new governors and almost all have new state legislators. In states’ with transition, a significant portion of the Medicaid Director’s time will be spent orienting these new leaders to their state’s Medicaid program: the budget, who and what the insurance covers, what the trade offs are for each potential policy decisions made, and opportunities to improve care while being strong stewards of taxpayer dollars.

Leadership transitions are also occurring as some Medicaid directors are leaving state service for new opportunities. New governors may be bringing in new Medicaid Directors, while some directors are simply ready for their next chapter. I reached out to national luminaries like Jami Snyder in Arizona, Suzanne Bierman in Nevada, and Stephen Groff in Delaware who are opting to pass the baton in their states. They have been preparing their teams for this time of transition and have each reflected that it’s a profoundly bittersweet milestone in their lives.

Receiving the baton, several newly appointed Medicaid Directors are looking at their state’s program with new eyes and fresh energy. Many, if not all, will also be experiencing imposter syndrome – who the heck decided that I should lead this program? – coupled with overwhelm at being accountable for the health of hundreds of thousands to millions of covered lives. Couple this with the realities likely ahead in 2023 around issues like the end of the national public health emergency, and the “hill” to climb will require unprecedented effort.

Who will be there to support and guide these new Directors as they step into leadership?

We will.

NAMD created the New Medicaid Director Roadmap which literally maps out the first year of a director’s service: the phases they will likely go through, what they can expect as they cycle through the year, how they might prioritize their time and energy. It also includes words of encouragement from other directors who’ve been there. It’s incredibly pragmatic and very cool.

And we hope it’s just the “hands on your back” they will need to not only succeed, but feel supported while they are succeeding. To say the job of a Medicaid Director is complex is an understatement of extraordinary proportions. It’s our job to provide the circle of support from our team to theirs, that will ultimately ensure that millions of Americans live their healthiest lives.

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