Chief administrative officer for the Montana health department's Healthcare Facilities Division, Jennifer Savage, left, and state Medicaid director, Mike Randol, right, appearing before state lawmakers in Helena on March 13, 2024. Credit: Mara Silvers / MTFP

The top Medicaid official in Montana’s state health department has submitted his resignation and will be taking a job in the private sector, an agency spokesperson said Thursday afternoon.

Mike Randol will leave the role of state Medicaid director almost two years after taking the position under the prior head of Gov. Greg Gianforte’s Department of Public Health and Human Services, Adam Meier. Department spokesperson Jon Ebelt said Randol’s resignation was accepted April 23 and his last day will be on May 10.

“Mike has made lasting contributions to Montana’s Medicaid program during his tenure with DPHHS,” health department director Charlie Brereton said in an emailed statement. “I’m grateful to Mike for his service and wish him well as he returns home to Kansas City and enters the private sector.”

Randol was previously employed at Cerner Corp., a health technology firm, before assuming the Montana position. Prior to that, he had run Medicaid programs in Iowa and Kansas. Ebelt did not respond immediately to additional questions about the company Randol is joining or the nature of his new job.

The state’s largest agency has seen a steady reshuffling of top leadership since Gianforte took office in 2021. Brereton, 29, took over as director in 2022 upon Meier’s departure, roughly a month after Randol joined the department. Other high-level departures include Human Services Executive Director Erica Johnston, a holdover from the administration of former Gov. Steve Bullock, and Chief Healthcare Facilities Officer Will Evo, who had been hired by Meier.

During Randol’s time in Montana, the department successfully applied for a Medicaid program waiver expansion that created new reimbursement opportunities for substance use disorder treatments and services, a key priority of the Gianforte administration. The agency also implemented massive increases to many Medicaid reimbursement rates across behavioral health, senior and long-term care and developmental disabilities sectors.

But the agency has also navigated complex challenges, many of which landed in Randol’s wheelhouse. He oversaw continued turmoil and staffing shortages at the Montana State Hospital in Warm Springs, which lost its federal certification before he joined the department. Additionally, over 120,000 Montanans lost Medicaid coverage as mass-eligibility reviews were conducted during the last year and Medicaid providers have complained about lags in Medicaid reimbursements and contract payments in recent months. 

Ebelt said Thursday that Brereton had appointed Rebecca de Camara, the current administrator of the Behavioral Health and Developmental Disabilities Division, as acting Medicaid director beginning May 13. De Camara’s position will be backfilled by deputy division administrator Meghan Peel.

Ebelt said the Healthcare Facilities Division, which includes the Montana State Hospital and is situated under Randol’s division, will report directly to Brereton in the interim.

The department, Ebelt continued, “will both consider internal candidates and launch a national search” for a new Medicaid director.

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Mara Silvers is the managing editor at Montana Free Press, where she has covered health policy, social services, politics and the judiciary since 2020. She was a 2023 data fellow with the USC Annenberg Center for Health Journalism, where she reported on racial disparities in Montana foster care. Mara has also helped produce and report audio projects for MTFP, including The Session and Shared State. Prior to MTFP, Mara was a radio and podcast producer for Slate, WNYC and Montana Public Radio. Her work has been featured in ProPublica, The Guardian and NPR. She lives in Helena, where she was born...